Organization
JAMES P. SERINO, O.D. P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES P SERINO O.D. (OPTOMETRIST)
(517) 783-6928
Entity
Organization
Contact information
Practice address
306 W WASHINGTON AVE, SUITE 104, JACKSON, MI 49201-2169
(517) 783-6928
(517) 784-9633
Mailing address
306 W WASHINGTON AVE, SUITE 104, JACKSON, MI 49201-2169
(517) 783-6928
(517) 784-9633
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003057
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200000004902
PHP OF SOUTH MICHIGAN
MI
01
—
410020815
PALMETTO GBA RR MEDICARE
MI
01
—
5448465
AETNA
MI
01
—
900C812040
BCBS OF MI
MI
Enumeration date
05/01/2007
Last updated
07/01/2010
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