Organization
BLUE MOUNTAIN EYE PLLC
Active
Organization
BLUE MOUNTAIN EYE PLLC
Active
Other names
Lifestyle Eye Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BENJAMIN M HIGGINBOTHAM (PRACTICE ADMINISTRATOR)
(509) 540-3937
Entity
Organization
Contact information
Practice address
1610 PENNY LN, WALLA WALLA, WA 99362-4477
(509) 540-3937
(509) 540-3938
Mailing address
PO BOX O, WALLA WALLA, WA 99362-0212
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
—
—
207WX0108X
Uveitis and Ocular Inflammatory Disease (Ophthalmology) Physician
—
—
207WX0120X
Cornea and External Diseases Specialist Physician
—
—
2083P0901X
Public Health & General Preventive Medicine Physician
—
—
Other
Enumeration date
10/27/2010
Last updated
01/22/2019
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