Organization
JABEKA INC.
Active
Other names
Franz Optical
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL LACKMAN O.D. (OWNER)
(541) 689-1115
Entity
Organization
Contact information
Practice address
65 DIVISION AVE, SUITE E, EUGENE, OR 97404-2485
(541) 689-1115
(541) 688-5585
Mailing address
65 DIVISION AVE, SUITE E, EUGENE, OR 97404-2485
(541) 689-1115
(541) 688-5585
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1856T
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02501-01
PACIFIC SOURCE
OR
01
—
049169002
BLUE CROSS
OR
05
—
083019
—
OR
01
—
111228
EYEMED
OR
01
—
3021
NORTHWEST BENEFIT NETWORK
OR
01
—
DO9351
RAILROAD MEDICARE PTAN
OR
Enumeration date
02/08/2006
Last updated
09/28/2011
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