Organization
EYE CLINIC OF ND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN TOWLE O.D. (ADMINISTRATOR)
(701) 255-4673
Entity
Organization
Contact information
Practice address
620 N 9TH ST, BISMARCK, ND 58501-4112
(701) 255-4673
(701) 255-4934
Mailing address
620 N 9TH ST, BISMARCK, ND 58501-4112
(701) 255-4673
(701) 255-4934
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013956
—
ND
01
—
202-001
BLUE SHIELD OF ND
ND
05
—
7779480
—
SD
Enumeration date
09/20/2006
Last updated
03/26/2013
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