Provider Demographics
NPI:1831745389
Name:DEEK VISION, PC
Entity type:Organization
Organization Name:DEEK VISION, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:DEEK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:810-610-7766
Mailing Address - Street 1:50045 LEXINGTON AVE E
Mailing Address - Street 2:
Mailing Address - City:SHELBY TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48317-6301
Mailing Address - Country:US
Mailing Address - Phone:810-610-7766
Mailing Address - Fax:
Practice Address - Street 1:26090 INGERSOL DR
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-1212
Practice Address - Country:US
Practice Address - Phone:248-277-4440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-12
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty