Organization
LAKESHORE PROFESSIONAL EYECARE PC
Active
Other names
Lakeshore Eyecare
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS L TOTTEN O.D. (PRESIDENT)
(231) 780-4700
Entity
Organization
Contact information
Practice address
951 SEMINOLE RD, SUITE 1, NORTON SHORES, MI 49441-4341
(231) 780-4700
(231) 780-4722
Mailing address
951 SEMINOLE RD, SUITE 1, NORTON SHORES, MI 49441-4341
(231) 780-4700
(231) 780-4722
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003038
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
944454950
—
MI
05
—
944454960
—
MI
Enumeration date
12/14/2007
Last updated
07/13/2015
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