Provider Demographics
NPI:1871774174
Name:SURGICAL EYE EXPERTS, LLC
Entity type:Organization
Organization Name:SURGICAL EYE EXPERTS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DAINES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-852-0600
Mailing Address - Street 1:385 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-3924
Mailing Address - Country:US
Mailing Address - Phone:508-453-8820
Mailing Address - Fax:
Practice Address - Street 1:385 GROVE ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-3924
Practice Address - Country:US
Practice Address - Phone:508-453-8820
Practice Address - Fax:508-791-4151
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RELIANT MEDICAL GROUP, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-15
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical