| |
E6112 E Bluffview Rd, Suite 102, Ironwood, MI 49938-9367 | |
(906) 932-1436 | |
(906) 932-1449 |
Full Name | |
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Type | Facility |
Speciality | Ophthalmology |
Location | E6112 E Bluffview Rd, Ironwood, Michigan |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1609034099 | NPI | - | NPPES |
700B710030 | Other | MI | BLUE CROSS BLUE SHIELD MI |
32849900 | Medicaid | WI | |
383005582010 | Other | WI | BLUE CROSS BLUE SHIELD OF WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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E6112 E Bluffview Rd, Ironwood, MI 49938-9367 Ph: (906) 932-1436 | E6112 E Bluffview Rd, Suite 102, Ironwood, MI 49938-9367 Ph: (906) 932-1436 |