Provider Demographics
NPI:1932200052
Name:EYE ASSOCIATES SIOUXLAND, P.L.C.
Entity Type:Organization
Organization Name:EYE ASSOCIATES SIOUXLAND, P.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-233-1529
Mailing Address - Street 1:2800 PIERCE ST STE 404
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51104-3759
Mailing Address - Country:US
Mailing Address - Phone:712-233-1529
Mailing Address - Fax:712-233-2040
Practice Address - Street 1:2800 PIERCE ST STE 404
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51104-3759
Practice Address - Country:US
Practice Address - Phone:712-233-1529
Practice Address - Fax:712-233-2040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA28135207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA52550OtherBCBS GROUP
IA0134510Medicaid
NE=========13Medicaid
IA52550OtherBCBS GROUP