BLACK AND WHITE LOOK OPTICAL CORPORATION (NPI# 1679660849) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679660849 |
| Entity Type | Organization |
| Organization Name | BLACK AND WHITE LOOK OPTICAL CORPORATION |
| Practice Address |
15675 W Ten Mile Rd Southfield MI 48075-2188 |
| Practice Telephone | 2485576444 |
| Practice Fax Number | 2485576501 |
| Mailing Telephone | 2485576444 |
| Mailing Fax Number | 2485576501 |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2013-03-08 |
| Authorized Official Name | MS. PHYLLIS FRYE (OFFICE MANAGER) |
| Authorized Official Telephone | 2485576444 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | MI | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | MIDWEST HEALTH PIN | 024599 | 01 |
| MI | BLUE CROSS PIN# | 900F378590 | 01 |
| MA | NVA PIN# | 230892 | 01 |
| MI | BLUE CROSS FEDERAL | 0F37859 | 01 |
| MI | TOTAL HEALTH PIN# | 113750 | 01 |
| MI | CO/OP PIN | 6719 | 01 |
| MI | 3282118 | 05 |
| Street Address |
15675 W TEN MILE RD |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48075-2188 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851900054 | K&b Medical Wigs, LLC | Durable Medical Equipment & Medical Supplies | 16250 Northland Dr. Ste 221, Southfield, MI 48075 | 2020-07-24 |
| 1790300390 | Julian Jeberaeel | Radiology | 2250 Providence, Southfield, MI 48075 | 2020-06-10 |
| 1265056410 | Husein Yusuf Husein | Podiatrist | Ascension Providence Hospital Southfield Campus, 16001 W. Nine Mile Rd. Depaul 2nd Floor, Southfield, Mi, MI 48075 | 2020-06-03 |
| 1952945420 | Paris Straughter | Nurse Practitioner | 18438 Onyx St, Southfield, MI 48075 | 2019-10-29 |
| 1811467657 | Medicine Man Medical, Pllc | Physical Medicine & Rehabilitation | 25130 Southfield Road, Suite #210, Southfield, MI 48075 | 2018-12-04 |
| 1447725528 | Rommel Ramos Perez | Physical Therapist | 26017 Greenfield Rd., Southfield, MI 48075 | 2018-10-04 |
| 1073009627 | Jacqueline Venora Goodgame | Licensed Practical Nurse | 4000 Town Ctr, Southfield, MI 48075 | 2018-07-06 |
| 1043712532 | Hollie Marie Maltese | Physical Therapy Assistant | 22255 Greenfiled 118, Southfield, MI 48075 | 2018-03-01 |
| 1932601481 | Katie Marie Mccormack | Occupational Therapist | 16001 West Nine Mile Rd., Southfield, MI 48075 | 2018-03-01 |
| 1801304241 | Absolute Hc LLC | Physical Therapist | 23461 Greenfield Rd Ste 200b, Southfield, MI 48075 | 2018-01-19 |
| Find all providers in zip 48075 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538777255 | James Bong-suk Kim | Optometrist | 19747 W 12 Mile Rd Ste L7a, Southfield, MI 48076-2584 | 2020-07-20 |
| 1154954741 | P-cor, LLC | Optometrist | 29350 Southfield Rd Ste 150, Southfield, MI 48076-2011 | 2020-02-21 |
| 1659754505 | Brittany R Adams | Optometrist | 29157 Southfield Rd, Southfield, MI 48076-1900 | 2015-07-09 |
| 1528382611 | Mobile Podiatry LLC | Optometrist | 27718 Franklin Road, Southfield, MI 48034 | 2010-03-18 |
| 1952420267 | Jartll Corp | Optometrist | 29983 Northwestern Hwy, Southfield, MI 48034-1020 | 2007-03-28 |
| 1831275759 | Martin Bruce Rudick | Optometrist | 28923 Christopher Ln., Southfield, MI 48034 | 2006-10-31 |
| 1548368954 | Holloway Eyecare PC | Optometrist | 20905 Greenfield Rd Ste 301, Southfield, MI 48075-5347 | 2006-09-20 |
| 1720197759 | Yaakov Gershon Zacks | Optometrist | 16232 Sherfield Pl, Southfield, MI 48075-2061 | 2006-08-30 |
| 1033141627 | Frances Meram Ceritano | Optometrist | 30800 Southfield Rd, Southfield, MI 48076-7737 | 2006-07-06 |
| 1205870532 | Agape Vision Associates P.C. | Optometrist | 24300 Southfield Rd Ste 216, Southfield, MI 48075-2859 | 2006-06-16 |
| Find all providers in SOUTHFIELD | ||||
| City | SOUTHFIELD |
| Zip Code | 48075 |
Please comment or provide details below to improve the information on BLACK AND WHITE LOOK OPTICAL CORPORATION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.