Organization
MIDWEST FAMILY EYE CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE M MCCALL OD (OPTOMETRIST/OWNER)
(218) 828-9545
Entity
Organization
Contact information
Practice address
7870 EXCELSIOR RD, BAXTER, MN 56425-8427
(218) 828-9545
(218) 828-1572
Mailing address
7870 EXCELSIOR RD, BAXTER, MN 56425-8427
(218) 828-9545
(218) 828-1572
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05N46MI
BLUE CROSS BLUE SHIELD, STAPLES
MN
01
—
05N76MI
BLUE CROSS BLUE SHIELD, GLASSES, STAPLES
MN
05
—
198523000
—
MN
01
—
46B88MI
BLUE CROSS BLUE SHIELD
MN
01
—
54B93MI
BLUE CROSS BLUE SHIELD-GLASSES
MN
01
—
DC7353
RAILROAD MEDICARE
MN
01
—
DD9020
RAILROAD MEDICARE
MN
Enumeration date
10/17/2006
Last updated
12/01/2014
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