Provider Demographics
NPI:1538877287
Name:WEXFORD EYECARE PC
Entity type:Organization
Organization Name:WEXFORD EYECARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:K
Authorized Official - Last Name:UNDEERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:724-935-5761
Mailing Address - Street 1:6400 BROOKTREE CT STE 220
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9271
Mailing Address - Country:US
Mailing Address - Phone:724-935-5761
Mailing Address - Fax:724-935-2245
Practice Address - Street 1:6400 BROOKTREE CT STE 220
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9271
Practice Address - Country:US
Practice Address - Phone:724-935-5761
Practice Address - Fax:724-935-2245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-11
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty