# DRS. RAVIN, BIRNDORF & RAVIN, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Specialty Eye Institute
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316043110
- **Authorized official:** THOMAS T ROARK (CEO)
- **Authorized official phone:** (517) 841-3007

## Contact information

- **Practice address:** 3000 REGENCY CT STE 100, TOLEDO, OH 43623-3081
- **Practice address phone:** (419) 882-2020
- **Practice address fax:** (419) 885-8440
- **Mailing address:** 850 W NORTH ST STE 104, JACKSON, MI 49202-3196
- **Mailing address phone:** (877) 852-8463
- **Mailing address fax:** (517) 817-0144

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |
| 207WX0107X | Retina Specialist (Ophthalmology) Physician | — | NULL | — |
| 207WX0107X | Retina Specialist (Ophthalmology) Physician | — | — | — |

## Other

- **Enumeration date:** 09/16/2006
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0630320 | — | OH |
| 01 | — | 180D661670 | BCBSM | MI |
| 01 | — | 900D610840 | BCBSM | MI |
| 01 | — | CA0110 | RAILROAD MEDICARE | MI |
| 01 | — | DE0364 | RAILROAD MEDICARE | MI |