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TRAVERSE CITY EYE CONSULTANTS P C NPI 1861554636


NPI Information

NPI: 1861554636
Provider Name: TRAVERSE CITY EYE CONSULTANTS P C
Classification: Ophthalmology - 207W00000X
Entity Type: Organization

CLIA Number: 23D1008119

Address:
419 S CORAL ST
KALKASKA, MI
ZIP 49646
Phone: (231) 935-8101
Get Directions

TRAVERSE CITY EYE CONSULTANTS P C is an ophthalmology in Kalkaska, MI. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. TRAVERSE CITY EYE CONSULTANTS P C NPI is 1861554636. The provider is registered as an organization entity type.

The provider's business location address is:

419 S CORAL ST
KALKASKA, MI
ZIP 49646-500
Phone: (231) 935-8101
Fax: (231) 935-0955

The provider's authorized official is Kenneth B Gum .
The authorized official title is Doctor and has the following contact phone number (231) 935-8101.

The CLIA number assigned to this NPI record is 23D1008119 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/15/2006 and was last updated on 3/30/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332H00000XEyewear SupplierNo
2207W00000XOphthalmologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10N89560MEDICAIDMICHIGAN
20N89570MEDICAIDMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.