Coastal Vision Center
LBN: Russell Stackhouse Md Pa
Coastal Vision Center is an health care organization with primary practice located at 6 S 14Th St , Fernandina FL 32034-3212. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Foot and Ankle Surgery. Allopathic & Osteopathic Physicians / Ophthalmology is the primary health care specialty.
Russell Stackhouse Md Pa can be contacted via phone (904) 261-5741, or through Barnett, Nichole Rene via phone (904) 261-5741.
Contact Information
Primary practice address
6 S 14Th St
Fernandina FL 32034-3212
Phone: (904) 261-5741
Fax: (904) 261-7383
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | ME117902 | Florida |
| Allopathic & Osteopathic Physicians / Foot and Ankle Surgery | 207XX0004X |
Profile Details
| NPI number | 1538655014 |
|---|---|
| LBN Legal business name | Russell Stackhouse Md Pa |
| DBA Doing business as | Coastal Vision Center |
| Authorized official | Barnett, Nichole Rene |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 8th, 2018 |
| Last updated | Dec 13th, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538655014 | NPPES |
| Other | 070583 | DATE OF BIRTH |
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