Provider Demographics
NPI:1770275661
Name:20-20 EYECARE OF WINONA LLC
Entity type:Organization
Organization Name:20-20 EYECARE OF WINONA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:PEGG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:662-845-4367
Mailing Address - Street 1:111 N FRONT ST
Mailing Address - Street 2:
Mailing Address - City:WINONA
Mailing Address - State:MS
Mailing Address - Zip Code:38967-2219
Mailing Address - Country:US
Mailing Address - Phone:662-845-4367
Mailing Address - Fax:
Practice Address - Street 1:111 N FRONT ST
Practice Address - Street 2:
Practice Address - City:WINONA
Practice Address - State:MS
Practice Address - Zip Code:38967-2219
Practice Address - Country:US
Practice Address - Phone:662-845-4367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty