Organization
MICHAEL L SUSSEX OD PC
Active
Parent organization
MICHAEL L SUSSEX OD PC
Other names
Sussex Vision Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
MICHAEL L SUSSEX OD PC
Authorized official
MICHAEL L SUSSEX OD (PRESIDENT OWNER)
(269) 651-2960
Entity
Organization
Contact information
Practice address
706 S CENTREVILLE RD, STURGIS, MI 49091
(269) 651-2960
(269) 657-4333
Mailing address
350 MARSHALL ST, COLDWATER, MI 49036
(517) 278-6303
(517) 279-8000
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
900A210070
BCBS
MI
05
—
941776997
—
MI
Enumeration date
06/05/2006
Last updated
08/05/2009
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