Eye Tech LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

TA0730 Issued in MD

Legal business name

EYE TECH LLC

Practice address

506 N Centre Street
Cumberland, MD 21502

Phone

(301) 722-6480

Fax

(301) 722-6294

NPI assigned

Jan 9, 2007

Organization subpart

No

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

Authorized official

Name

Robert R Mitter, OD

Title

Physician Owner

Phone

(301) 722-6480

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333584000000",
    "number": "1104975150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 N CENTRE STREET",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "21502",
            "telephone_number": "301-722-6480",
            "fax_number": "301-722-6294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 N CENTRE STREET",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "21502",
            "telephone_number": "301-722-6480",
            "fax_number": "301-722-6294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE TECH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2012-04-05",
        "status": "A",
        "authorized_official_last_name": "MITTER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "301-722-6480",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA0730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "763448000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Renato R Espina, M.D.
• Allison L Evans-Wood, D.O.
• Lucinda Ruth Everett, CRNP
• Brody Adam Evix, M.S., CF-SLP
• Kristen Dawn Ewing, PA-C
• F Daniel Jackson, MD, PA
• F. Daniel Jackson, MD, PA
• F. Daniel Jackson, MD, PA D/B/a Labwork LLC
• F. Daniel Jackson, MD, PA T/a the Imaging Center
• Tara Fach

• Optometrist in Cumberland, MD
• Providers in Cumberland, MD by specialty
• Optometrist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; 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.