Individual
DR. ERIC D PORISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
605 SAINT JOSEPH ST, RAPID CITY, SD 57701-2718
(605) 341-5644
(605) 341-5450
Mailing address
605 SAINT JOSEPH ST, RAPID CITY, SD 57701-2718
(605) 341-5644
(605) 341-5450
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
604
SD
152WC0802X
Corneal and Contact Management Optometrist
604
SD
152WP0200X
Pediatric Optometrist
604
SD
152WS0006X
Sports Vision Optometrist
604
SD
152WX0102X
Occupational Vision Optometrist
604
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11336062
CAQH
SD
05
—
9203370
—
SD
01
—
S100185
MEDICARE ID
SD
Enumeration date
01/15/2006
Last updated
01/25/2008
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