Eye Health of Houghton Lake, P.L.L.C.
Organization Active NPI Optometrist · Houghton Lake, MI
NPI 1295924587 · NPPES record last updated Oct 23, 2007
Key facts
- NPI
- 1295924587
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 4901004270 (MI)
- Legal business name
- EYE HEALTH OF HOUGHTON LAKE, P.L.L.C.
- Practice address
- 2129 W Houghton Lake Dr
Houghton Lake, MI 48629-8236 - Phone
- (989) 366-6344
- Fax
- (989) 366-6390
- NPI assigned
- Oct 23, 2007
- Organization subpart
- No
Authorized official
- Name
- Lauren Elizabeth Skarnulis, O.D.
- Title
- Optometrist
- Phone
- (231) 633-4210
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071214000068 | MI | Part B Supplier - Clinic/Group Practice | 6709976715 |
Receives reassigned benefits from 1 practitioner Practice locations: Houghton Lake, MI; Traverse City, MI |
National Provider Directory
Locations
2129 W Houghton Lake Dr
Houghton Lake, MI 48629
Phone (989) 366-6344
2401 US 31 S
Traverse City, MI 49684
Phone (231) 995-0207
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 4901004270 | MI | Yes |
Addresses
Primary practice location
2129 W Houghton Lake Dr
Houghton Lake, MI 48629-8236
Mailing address
8154 Bel Cherrie Dr
Traverse City, MI 49686-1637
Phone (231) 633-4210
Other providers in Houghton Lake, MI
- Doctors K&R HL PLLC
- Mercedes Erica Emard
- Endovascular Physicians of Michigan PC
- Ashley English
- David Mark Essmaker
- Jamie Ann Fagerlie
- Family Eye Care PC
- Maryann T Fleischmann Frick
- Allison Marie Forbes
- Sarah Lynn Forrest
All providers in Houghton Lake, MI · Optometrist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 23, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.