Organization
RX OPTICAL LABORATORIES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHAN J JEPSON (PRESIDENT)
(269) 342-0003
Entity
Organization
Contact information
Practice address
1700 S PARK ST, KALAMAZOO, MI 49001-2759
(269) 342-0003
(269) 342-4284
Mailing address
1825 SOUTH PARK ST, KALAMAZOO, MI 49001-2759
(269) 342-0003
(269) 342-4284
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003762
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
900C976550
BCBS OF MICHIGAN
MI
Enumeration date
06/25/2006
Last updated
12/08/2017
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