Organization
EYE GUYS
Active
Other names
The Eye Guys
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD CARL GODNIG JR. O.D. (OWNER)
(907) 439-3917
Entity
Organization
Contact information
Practice address
390 N MAIN ST, WASILLA, AK 99654-7017
(907) 376-3917
(907) 376-3967
Mailing address
390 N MAIN ST, WASILLA, AK 99654-7017
(907) 376-3917
(907) 376-3967
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
212
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
161057
MEDICARE PTAN
—
05
—
OD4478
—
AK
Enumeration date
10/16/2009
Last updated
10/16/2009
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