Provider Demographics
NPI:1982688412
Name:EXPERIENCE YOUR EYE SPECIALIST, PLC
Entity Type:Organization
Organization Name:EXPERIENCE YOUR EYE SPECIALIST, PLC
Other - Org Name:EYES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:NORFLEET
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:989-684-7121
Mailing Address - Street 1:3941 TRAXLER COURT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706
Mailing Address - Country:US
Mailing Address - Phone:989-684-7121
Mailing Address - Fax:989-684-7677
Practice Address - Street 1:3941 TRAXLER COURT
Practice Address - Street 2:SUITE 100
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706
Practice Address - Country:US
Practice Address - Phone:989-684-7121
Practice Address - Fax:989-684-7677
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EXPERIENCE YOUR EYE SPECIALIST, PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-11-29
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4487020Medicaid
MI900Z910390OtherBCBS
MI1018659OtherMCLAREN
MI1018658OtherMCLAREN
MI900Z910390OtherBCBS
MI4487020Medicaid