Organization
WEIR EYE CLINIC LLC
Active
Other names
Weir Eye Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN C WEIR O.D. (OWNER)
(701) 483-2200
Entity
Organization
Contact information
Practice address
849 3RD AVE W, DICKINSON, ND 58601-3810
(701) 483-2200
(701) 483-9333
Mailing address
849 3RD AVE W, DICKINSON, ND 58601-3810
(701) 483-2200
(701) 483-9333
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
459
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
356694
MT MEDICAID
MT
05
—
60630
—
ND
01
—
DE6860
PALMETTO GBA-RR MEDICARE
ND
Enumeration date
07/08/2005
Last updated
11/06/2007
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