Organization
MARION EYE CENTERS LTD.
Active
Other names
Marion Eye Centers, Ltd.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAQBOOL AHMAD (PRESIDENT/OWNER)
(618) 993-3838
Entity
Organization
Contact information
Practice address
1200 W DEYOUNG ST, MARION, IL 62959-4437
(618) 993-5686
(618) 997-5595
Mailing address
1200 W DEYOUNG ST, P.O. BOX 1178, MARION, IL 62959-4437
(618) 993-5686
(618) 997-5505
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
036-051996
IL
207W00000X
Ophthalmology Physician
Primary
036-051996
IL
207WX0107X
Retina Specialist (Ophthalmology) Physician
036.051996
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036051996
—
IL
05
—
203169800
—
MO
01
—
791580195
MEDICARE RAILROAD
—
01
—
CA2196 GROUP PTAN
MEDICARE RAILROAD
IL
Enumeration date
07/20/2005
Last updated
07/31/2017
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