Organization
MID MICHIGAN FAMILY EYE CARE PLLC
Active
Other names
Mid Michigan Eye
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN MICHAEL HALES O.D. (OPTOMETRIST)
(989) 435-2020
Entity
Organization
Contact information
Practice address
334 N ROSS ST, BEAVERTON, MI 48612-8165
(989) 435-2020
(989) 435-2554
Mailing address
PO BOX 505, BEAVERTON, MI 48612-0505
(989) 435-2020
(989) 435-2554
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004640
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0A80041
BLUECROSS BLUESHIED
MI
05
—
1356698534
—
MI
Enumeration date
08/07/2012
Last updated
06/28/2013
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