Provider Demographics
NPI:1205971975
Name:LOVCIK, ANTHONY LOUIS (OD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:LOUIS
Last Name:LOVCIK
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 1:7516 MARINER DR
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55311-2613
Mailing Address - Country:US
Mailing Address - Phone:763-420-6647
Mailing Address - Fax:763-416-4084
Practice Address - Street 1:12131 ELM CREEK BLVD N
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-7093
Practice Address - Country:US
Practice Address - Phone:763-416-1983
Practice Address - Fax:763-416-4084
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNMN2638152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FMHP37578OtherHEALTH PARTNERS
MN219101031048OtherPREFFERED
MN60P14L0OtherBCBS
FM2124155OtherAMERICAS PPO
MN2202189OtherMEDICA
MN2202456OtherMEDICA BROOKDALE