Organization
JUDISCH VISION PC
Active
Other names
Rock Judisch Vision Clinic PC
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN PAUL JUDISCH OD (PRESIDENT)
(712) 657-3304
Entity
Organization
Contact information
Practice address
1160 3RD ST, LAKE VIEW, IA 51450-0080
(712) 657-3304
(712) 657-3303
Mailing address
PO BOX 80, 1160 3RD ST, LAKE VIEW, IA 51450-0080
(712) 657-3304
(712) 657-3303
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
02262
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0258194
—
IA
01
—
25818
BCBS
—
01
—
DA3270
RR MEDICARE
—
Enumeration date
01/24/2007
Last updated
05/07/2021
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