Individual
DR. CARL LOUIS STITES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
6840 NORTHWAY DR NE, SUITE A, ROCKFORD, MI 49341-7568
(616) 863-2020
Mailing address
6840 NORTHWAY DR NE, SUITE A, ROCKFORD, MI 49341-7568
(616) 863-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003291
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
900D117550
BCBSM
MI
Enumeration date
08/22/2005
Last updated
06/08/2010
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