Organization
PETERS FAMILY EYECARE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDY L PETERS (O.D./OWNER)
(419) 636-3937
Entity
Organization
Contact information
Practice address
219 S MAIN ST, BRYAN, OH 43506-1759
(419) 636-3937
(419) 636-2302
Mailing address
219 S MAIN ST, BRYAN, OH 43506-1759
(419) 636-3937
(419) 636-2302
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4624/T1371
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000139777
ANTHEM BCBS PIN
OH
01
—
343703198007
MEDICAL MUTUAL OHIO PIN
OH
Enumeration date
08/29/2007
Last updated
06/24/2022
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