Eye Care Providers of Michigan PC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

EYE CARE PROVIDERS OF MICHIGAN PC

Practice address

1000 Pine Grove Ave
Port Huron, MI 48060-3733

Phone

(810) 982-3200

Fax

(810) 982-4480

NPI assigned

Feb 22, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Norbert P Czajkowski, MD

Title

Owner Director

Phone

(586) 296-7250

Specialties & licenses 1

Addresses

Other names 1

• Eye Care Center of Port Huron Doing business as

Tax ID family

Eye Care Center of Port Huron3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Eye Care Providers of Michigan PC

  • Ophthalmology Physician
  • Port Huron, MI
  • NPI 1134254071
  NPD tax ID
• Eye Care Providers of Michigan PC

  • Optometrist
  • Fraser, MI
  • NPI 1225163165
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043345986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26010",
            "city": "FRASER",
            "state": "MI",
            "postal_code": "480266010",
            "telephone_number": "586-296-7250",
            "fax_number": "586-296-0276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 PINE GROVE AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603733",
            "telephone_number": "810-982-3200",
            "fax_number": "810-982-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CARE PROVIDERS OF MICHIGAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CZAJKOWSKI",
        "authorized_official_first_name": "NORBERT",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER DIRECTOR",
        "authorized_official_telephone_number": "586-296-7250",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Care Center of Port Huron",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kaitlyn Marie Enders, B.S.
• Enlightened Mind LLC
• Donald D Ernst, D.O.
• Thomas Kevin Ernst, DPM
• Stephanie Evans, LLMSW
• Eye Care Providers of Michigan PC
• Moeta Ziarra Fabelo
• Laura W Fadell, LLP
• Laurie Lee Fagan, LBSW
• Gudalia Fajardo

• Optometrist in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.