Provider Demographics
NPI:1952501231
Name:EYES, P.A.
Entity Type:Organization
Organization Name:EYES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:H
Authorized Official - Last Name:GONYEA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:207-667-8615
Mailing Address - Street 1:82 WATER ST
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:ME
Mailing Address - Zip Code:04605-2006
Mailing Address - Country:US
Mailing Address - Phone:207-667-8615
Mailing Address - Fax:207-667-4212
Practice Address - Street 1:1049 MAIN STREET
Practice Address - Street 2:
Practice Address - City:MOUNT DESERT
Practice Address - State:ME
Practice Address - Zip Code:04660-0232
Practice Address - Country:US
Practice Address - Phone:207-244-1180
Practice Address - Fax:207-244-1181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME125710001Medicaid
ME125710001Medicaid
MM5291Medicare PIN