Provider Demographics
NPI:1922472505
Name:FOCUS 313 EYECARE, P.C.
Entity Type:Organization
Organization Name:FOCUS 313 EYECARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSONBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:313-473-9339
Mailing Address - Street 1:17135 KERCHEVAL AVE
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48230-1660
Mailing Address - Country:US
Mailing Address - Phone:313-473-9339
Mailing Address - Fax:313-406-7254
Practice Address - Street 1:17135 KERCHEVAL AVE
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE
Practice Address - State:MI
Practice Address - Zip Code:48230-1660
Practice Address - Country:US
Practice Address - Phone:313-473-9339
Practice Address - Fax:313-406-7254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-19
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004540152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty