Organization
EYE CLINIC OF FARIBAULT PA
Active
Other names
Richie Eye Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL G RICHIE (MD/OWNER)
(507) 332-9900
Entity
Organization
Contact information
Practice address
1575 20TH ST NW STE 101, FARIBAULT, MN 55021-2930
(507) 332-9900
(507) 332-6800
Mailing address
1575 20TH ST NW STE 101, FARIBAULT, MN 55021-2930
(507) 332-9900
(507) 332-6800
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
5584709
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
496436500
—
MN
01
—
DA3675
RAILROAD MEDICARE
MN
Enumeration date
04/17/2006
Last updated
01/11/2021
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