Mickelson Eye Clinic, Pa

LBN: Mickelson Eye Clinic, Pa
Mickelson Eye Clinic, Pa is an health care organization with primary practice located at 126 Labree Ave S , Thief River Falls MN 56701-2819. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Mickelson Eye Clinic, Pa can be contacted via phone (218) 683-3937, or through Mickelson, Craig R via phone (218) 683-3937.

Contact Information

Primary practice address
126 Labree Ave S Thief River Falls MN 56701-2819
Fax: (218) 683-4557
Website:
Authorized official contact:
Name: Mickelson, Craig R

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1891 Minnesota

Profile Details

NPI number 1972528776
LBN Legal business name Mickelson Eye Clinic, Pa
DBA Doing business as
Authorized official Mickelson, Craig R
Entity Organization
Organization subpart 1 No
Enumeration date Jul 13th, 2006
Last updated Apr 17th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972528776 NPPES
Minnesota Other 1026440 PREFERRED ONE
Minnesota Other 2201140 PREFERRED ONE
Minnesota Other 71973 PREFERRED ONE
Minnesota Other 140661 PREFERRED ONE
Minnesota Other 61B37MI PREFERRED ONE

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