Organization
LUFKIN EYE CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE SIONE TANABE MD (OWNER PRESIDENT)
(651) 292-8200
Entity
Organization
Contact information
Practice address
280 SMITH AVE N, #400, SAINT PAUL, MN 55102-2424
(651) 292-8200
(651) 292-1801
Mailing address
PO BOX 18128, W ST PAUL, MN 55118-0128
(651) 292-8205
(651) 292-1801
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25312LU
MN BLUE CROSS
MN
05
—
608512100
—
MN
Enumeration date
09/15/2006
Last updated
04/27/2017
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