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Organization
EAGLE EYE SURGERY AND LASER CENTER LLC
Active
Organization
EAGLE EYE SURGERY AND LASER CENTER LLC
Active
Other names
Eagle Eye Surgery & Laser Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY SNODGRASS (PRESIDENT)
(615) 665-1283
Entity
Organization
Contact information
Practice address
3090 E GENTRY WAY STE 100, MERIDIAN, ID 83642-3548
(208) 288-1600
(208) 288-4299
Mailing address
1A BURTON HILLS BLVD STE 300, ATTN: L&C, NASHVILLE, TN 37215-6153
(615) 665-1283
(615) 234-1720
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010029603
REGENCE BLUE SHIELD
ID
01
—
04093
BLUE CROSS
ID
05
—
150695
—
OR
01
—
490004716
RAILROAD MEDICARE
ID
05
—
805834800
—
ID
Enumeration date
03/21/2007
Last updated
09/08/2026
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