Organization
EYECARE ASSOCIATES OF HASLETT, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PENNY JACKSON (BILLER)
(517) 697-0845
Entity
Organization
Contact information
Practice address
124 N MAIN, PERRY, MI 48872-5103
(517) 697-0845
Mailing address
PO BOX 116, PERRY, MI 48872-0116
(517) 697-0845
(517) 940-9236
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
152WC0802X
Corneal and Contact Management Optometrist
—
—
152WL0500X
Low Vision Rehabilitation Optometrist
—
—
152WP0200X
Pediatric Optometrist
—
—
152WX0102X
Occupational Vision Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
900C31188-0
BCBS OF MICHIGAN
MI
Enumeration date
10/12/2005
Last updated
04/29/2026
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