# MEDICAL EYE CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609944347
- **Authorized official:** KEITH CASEBOLT (CEO)
- **Authorized official phone:** (541) 779-4711

## Contact information

- **Practice address:** 1333 E BARNETT RD, MEDFORD, OR 97504-8219
- **Practice address phone:** (541) 779-4711
- **Practice address fax:** (541) 618-1485
- **Mailing address:** 1333 E BARNETT RD, MEDFORD, OR 97504-8219
- **Mailing address phone:** (541) 779-4711
- **Mailing address fax:** (541) 618-1485

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/01/2006
- **Last updated:** 07/26/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 181860972 | RAILROAD MEDICARE | — |
| 05 | — | 212605 | — | OR |