Organization
MINNESOTA EYE CONSULTANTS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLIFTON CHAD BAZHAW (CHIEF REVENUE OFFICER)
(469) 270-6658
Entity
Organization
Contact information
Practice address
9801 DUPONT AVE SOUTH, SUITE 200, BLOOMINGTON, MN 55431-3180
(952) 888-5800
(952) 567-6156
Mailing address
9801 DUPONT AVE S STE 425, BLOOMINGTON, MN 55431-3873
(952) 888-5800
(952) 567-6156
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
1751
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
334216601
—
MN
01
—
59Q32MI
BCBS GROUP OPTICAL
MN
Enumeration date
02/01/2006
Last updated
11/04/2025
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