Provider Demographics
NPI:1932267226
Name:VISION ASSOCIATES PC
Entity Type:Organization
Organization Name:VISION ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:POGGIOLO
Authorized Official - Suffix:SR
Authorized Official - Credentials:OD
Authorized Official - Phone:586-777-0060
Mailing Address - Street 1:28532 SCHOENHERR
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088
Mailing Address - Country:US
Mailing Address - Phone:586-777-0060
Mailing Address - Fax:586-777-1501
Practice Address - Street 1:28532 SCHOENHERR RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-4329
Practice Address - Country:US
Practice Address - Phone:586-777-0060
Practice Address - Fax:586-777-1501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0281060001Medicare NSC