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Contact Information

SUBURBAN OPTOMETRICS ASSOC P C
32415 5 MILE RD
LIVONIA, MI48154-3039
 Phone: 734-525-8170
 Fax: 734-525-0726
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
 

Low Vision Rehabilitation

152WL0500X 41 Optometry
 

Vision Therapy

152WV0400X 41 Optometry
Indicates primary specialty

NPI Profile & details for SUBURBAN OPTOMETRICS ASSOC P C

NPI # 1952518748
LBN Legal business name SUBURBAN OPTOMETRICS ASSOC P C
Authorized official JOHN JACOBI - (OPTOMETRIST)
Entity Organization
Organization subpart 1 No
Enumeration date 05/17/2007
Last updated 03/22/2016 - About 10 years ago
Identifiers
MI License # 4901003184
MI License # 4901003208
MI License # 4901004024
MI License # 4901004851
MI Medicaid 2603194
MI Medicaid 4309851
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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