| Birch Lake Vision Group, Llc. | |
|
4720 White Bear Pkwy, White Bear Lake, MN 55110-3336 | |
| (651) 426-2747 | |
| (651) 426-9838 |
| Full Name | Birch Lake Vision Group, Llc. |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 4720 White Bear Pkwy, White Bear Lake, Minnesota |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609921899 | NPI | - | NPPES |
| 22-01733 | Other | MN | MEDICA (BIRCH LAKE) |
| 244ROLU | Other | MN | BLUE CROSS BLUE SHIELD |
| P00116310 | Other | MN | MEDICARE RAILROAD RETIREM |
| P00124841 | Other | MN | MEDICARE RAILROAD RETIREM |
| 22-02690 | Other | MN | MEDICA (BIRCH LAKE) |
| 965401019270 | Other | MN | PREFERRED ONE |
| 22-02779 | Other | MN | MEDICA (VILLAGE) |
| HP29577 | Other | MN | HEALTH PARTNERS |
| ON456GR | Other | MN | BCBS |
| 22-02780 | Other | MN | MEDICA (VILLAGE CLINIC) |
| 965400656001 | Other | MN | PREFERRED ONE |
| HP27080 | Other | MN | HEALTH PARTNERS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | LD2695000 (Minnesota) | Secondary |
| 152W00000X | Optometrist | LD1732000 (Minnesota) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Birch Lake Vision Group, Llc. 4720 White Bear Pkwy, White Bear Lake, MN 55110-3336 Ph: (651) 426-2747 | Birch Lake Vision Group, Llc. 4720 White Bear Pkwy, White Bear Lake, MN 55110-3336 Ph: (651) 426-2747 |
Jaclyn Elizabeth Doffin, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 4750 Washington Sq, White Bear Lake, MN 55110 Phone: 651-429-3379 Fax: 651-429-8681 | |
Dr. Paul Christopher Onderick, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 3827 White Bear Ave N, White Bear Lake, MN 55110 Phone: 651-426-1051 | |
Dr. Brian Dwight Grudem, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 4720 White Bear Pkwy, White Bear Lake, MN 55110 Phone: 651-426-2747 Fax: 651-426-9838 | |
Doffin Family Eye Care Pa Optometrist Medicare: Medicare Enrolled Practice Location: 4750 Washington Sq, White Bear Lake, MN 55110 Phone: 651-429-3379 Fax: 651-429-8681 | |
Dr. Kevin David Lucas, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 4720 White Bear Pkwy, White Bear Lake, MN 55110 Phone: 651-426-2747 Fax: 651-426-9838 | |
Elizabeth A Roberts, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 4750 Washington Sq, White Bear Lake, MN 55110 Phone: 651-429-3379 Fax: 651-429-8681 | |
Allyson K Caspers, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 4750 Washington Sq, White Bear Lake, MN 55110 Phone: 651-429-3379 Fax: 651-429-8681 |