Organization
COFFMAN VISION CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL A COFFMAN O.D. (PRESIDENT)
(541) 389-4774
Entity
Organization
Contact information
Practice address
61535 S HIGHWAY 97, STE. 16, BEND, OR 97702-2154
(541) 389-4774
(541) 389-3971
Mailing address
61535 S HIGHWAY 97, STE. 16, BEND, OR 97702-2154
(541) 389-4774
(541) 389-3971
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2508T
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1982799789
INDIVIDUAL NPI
OR
01
—
R116227
MEDICARE GROUP #
OR
Enumeration date
11/30/2006
Last updated
04/17/2015
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