Deltavision Optical Center PC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

DELTAVISION OPTICAL CENTER PC

Practice address

G3541 Miller Rd
Flint, MI 48507-1235

Phone

(810) 732-8610

Fax

(810) 732-6813

NPI assigned

Oct 14, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Irving Ira Foon, O.D.

Title

President

Phone

(810) 732-8610

Specialties & licenses 1

Addresses

Other identifiers 5

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093704850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "G3541 MILLER RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485071235",
            "telephone_number": "810-732-8610",
            "fax_number": "810-732-6813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "G3541 MILLER RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485071235",
            "telephone_number": "810-732-8610",
            "fax_number": "810-732-6813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTAVISION OPTICAL CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FOON",
        "authorized_official_first_name": "IRVING",
        "authorized_official_middle_name": "IRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "810-732-8610",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NVA",
            "identifier": "230370",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN MEDICAID",
            "identifier": "1004305",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLE",
            "identifier": "31986",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7333067",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "27671",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Flint, MI
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• 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.