Provider Demographics
NPI:1902943533
Name:CHILDREN'S EYE CLINIC, PC
Entity Type:Organization
Organization Name:CHILDREN'S EYE CLINIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:515-222-1180
Mailing Address - Street 1:6000 UNIVERSITY AVENUE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266
Mailing Address - Country:US
Mailing Address - Phone:515-222-1180
Mailing Address - Fax:515-222-9635
Practice Address - Street 1:6000 UNIVERSITY AVENUE
Practice Address - Street 2:SUITE 210
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266
Practice Address - Country:US
Practice Address - Phone:515-222-1180
Practice Address - Fax:515-222-9635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty