Organization
CEDAR RUN EYE CENTER, PLLC
Active
Organization
CEDAR RUN EYE CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY B. HANLEY M.D. (OWNER)
(231) 929-3888
Entity
Organization
Contact information
Practice address
3830 W FRONT ST, TRAVERSE CITY, MI 49684-8153
(231) 929-3888
(231) 929-4365
Mailing address
3830 W FRONT ST, TRAVERSE CITY, MI 49684-8153
(231) 929-3888
(231) 929-4365
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
4901003086
MI
152W00000X
Optometrist
4901003094
MI
152W00000X
Optometrist
4901004107
MI
207W00000X
Ophthalmology Physician
Primary
4301048021
MI
332B00000X
Durable Medical Equipment & Medical Supplies
4301048021
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1020070001
DMERC REGION B
MI
01
—
102022
PREFERRED CHOICE
MI
05
—
103164508
—
MI
01
—
1134113517
RAILROAD MEDICARE/CIZEK
MI
01
—
1144214180
RAILROAD MEDICARE/HANLEY
MI
01
—
1497736102
RAILROAD MEDICARE/HUMMEL
MI
01
—
180B86357
BCBS TBH
MI
01
—
900001413
PRIORITY - CREC
MI
01
—
900B86347
BCBS OPTOM GROUP
MI
01
—
900B86347001
BCBSM
MI
01
—
900B86347003
BCBSM
MI
05
—
943166469
—
MI
05
—
943166487
—
MI
05
—
943166496
—
MI
01
—
CG1308
RAILROAD MEDICARE/TSC
MI
01
—
CN1586
RAILROAD MEDICARE/CREC
MI
Enumeration date
12/14/2006
Last updated
05/11/2015
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