Organization
LAWRENCE I. HITTLE, O.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE I HITTLE O.D. (PRESIDENT)
(208) 283-4342
Entity
Organization
Contact information
Practice address
205 12TH ST S, SAUK CENTRE, MN 56378-1614
(320) 352-0146
(320) 352-0023
Mailing address
205 12TH ST S, SAUK CENTRE, MN 56378-1614
(320) 352-0146
(320) 352-0023
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3089
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01052855
PREFERRED ONE
MN
01
—
0AY76LA
BCBSMN
MN
01
—
2204671
MEDICA
MN
01
—
714467000
MINNESOTA HEALTH CARE PROGRAMS
MN
Enumeration date
07/08/2009
Last updated
09/21/2009
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