Organization
THE EYE DOCTORS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP G SIETSTRA OD (OPTOMETRIST)
(605) 338-7104
Entity
Organization
Contact information
Practice address
5116 S WESTERN AVE, SIOUX FALLS, SD 57108-2677
(605) 338-7104
(605) 575-3880
Mailing address
5116 S WESTERN AVE, SIOUX FALLS, SD 57108-2677
(605) 338-7104
(605) 575-3880
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
208
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57D33TH
BCBS OF MN
—
01
—
CI5913
RR MEDICARE
—
Enumeration date
08/02/2005
Last updated
09/02/2011
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