National Provider Identifier Database

NORTHWEST EYE CLINIC LLC
Ophthalmology

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.


Contact Information

NORTHWEST EYE CLINIC, LLC
250 CENTRAL AVE N STE 107
WAYZATA, MN55391-1207
Phone: 763-416-7600
Fax: 763-416-7634
Website:
Specialty Taxonomy Code
* Ophthalmology 207W00000X

* Indicates primary specialty

NPI Profile & details for NORTHWEST EYE CLINIC, LLC

NPI Number 1891871646
Legal business name
LBN
NORTHWEST EYE CLINIC, LLC
Authorized official KELLY PETTENGILL - (CREDENTIALING AND DATA MANAGEMENT)
Entity Organization
Organization subpart No
Enumeration date 10/27/2006
Last updated 03/18/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • MN License #: 360
  • MN Medicaid: 607693900

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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