Organization
PINNACLE EYECARE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN JACOBS O.D. (PRESIDENT)
(517) 337-1832
Entity
Organization
Contact information
Practice address
139 W LAKE LANSING RD STE 115, EAST LANSING, MI 48823-8525
(517) 337-1832
(517) 337-1854
Mailing address
139 W LAKE LANSING RD STE 115, EAST LANSING, MI 48823-8525
(517) 337-1832
(517) 337-1854
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004013
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1019456
MCLAREN
MI
01
—
200000002155
PHPMM
MI
01
—
5658590001
MEDICARE DME
MI
05
—
864792288
—
MI
01
—
900C313100
BCBS
MI
05
—
944753842
—
MI
Enumeration date
06/24/2008
Last updated
06/24/2008
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