Organization
DOFFIN FAMILY EYE CARE PA
Active
Other names
White Bear Eye Clinic and Optical
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE OLUFSON (INSURANCE MANAGER)
(651) 429-3379
Entity
Organization
Contact information
Practice address
4750 WASHINGTON SQ, WHITE BEAR LAKE, MN 55110-3257
(651) 429-3379
(651) 429-8681
Mailing address
4750 WASHINGTON SQ, WHITE BEAR LAKE, MN 55110-3257
(651) 429-3379
(651) 429-8681
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105474
UCARE
MN
01
—
2117748
MEDICA-DME
MN
01
—
2200089
MEDICA
MN
01
—
27679RU
BLUE CROSS BLUE SHIELD
MN
01
—
29623WH
BLUE CROSS BLUE SHIELD
MN
05
—
307262200
—
MN
Enumeration date
05/12/2006
Last updated
09/25/2017
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