Lakeview Vision Center, LLC
Organization Active NPI Optometrist · Lakeview, OR
NPI 1164597225 · NPPES record last updated Nov 19, 2008
Key facts
- NPI
- 1164597225
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 961ATI (OR)
- Legal business name
- LAKEVIEW VISION CENTER, LLC
- Practice address
- 628 N 1St St Ste C
Lakeview, OR 97630-1506 - Phone
- (541) 947-3357
- Fax
- (541) 947-3368
- NPI assigned
- Nov 22, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Garry Dwayne Kappel, O D
- Title
- Owner
- Phone
- (541) 947-3357
Practitioners 1
-
James R Hathaway, OD
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 961ATI | OR | Yes |
Addresses
Primary practice location
628 N 1St St Ste C
Lakeview, OR 97630-1506
Mailing address
628 N 1St St Ste C
Lakeview, OR 97630-1506
Phone (541) 947-3357
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 023632 | Medicaid | OR |
Other providers in Lakeview, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.