Provider Demographics
NPI:1013918069
Name:BUDGE, JAMES E (OD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:BUDGE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 COOLIDGE RD
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-1378
Mailing Address - Country:US
Mailing Address - Phone:517-337-0316
Mailing Address - Fax:517-337-1779
Practice Address - Street 1:5100 MARSH RD STE H
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-1195
Practice Address - Country:US
Practice Address - Phone:517-349-0150
Practice Address - Fax:517-349-0157
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003045152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
200000026817OtherPHP
MI2270043OtherPHP FAMILY CARE
MI2877733Medicaid
MI4901003045OtherSTATE LICENSE
MI990008092OtherRAILROAD MEDICARE
MI900C365300OtherMICHIGAN BCBS
MI2200043OtherPHP OF MID MI
900C36357OtherBCBSM
MI2200043OtherPHP OF MID MI
MI2270043OtherPHP FAMILY CARE