Organization
LANSING OPHTHALMOLOGY, P.C.
Active
Other names
LO Eye Care
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD SHOOK (EXECUTIVE DIRECTOR)
(517) 337-1899
Entity
Organization
Contact information
Practice address
2001 COOLIDGE RD, EAST LANSING, MI 48823-1378
(517) 337-1668
(517) 337-1779
Mailing address
1005 CHARLEVOIX DR STE 100, GRAND LEDGE, MI 48837-8186
(517) 337-1668
(517) 622-1205
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
—
—
207WX0107X
Retina Specialist (Ophthalmology) Physician
—
—
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180C36002
BCBSM
MI
01
—
CE4235
RAILROAD MEDICARE
MI
Enumeration date
11/21/2005
Last updated
10/31/2024
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