Provider Demographics
NPI:1437261880
Name:EMPIRE EYE PHYSICIANS P S
Entity type:Organization
Organization Name:EMPIRE EYE PHYSICIANS P S
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:W
Authorized Official - Last Name:STURBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-928-8040
Mailing Address - Street 1:1414 N HOUK ROAD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99216-1097
Mailing Address - Country:US
Mailing Address - Phone:509-928-8040
Mailing Address - Fax:509-928-0784
Practice Address - Street 1:1414 N HOUK ROAD
Practice Address - Street 2:SUITE 102
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99216-1097
Practice Address - Country:US
Practice Address - Phone:509-928-8040
Practice Address - Fax:509-928-0784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7136930Medicaid
ID807694500Medicaid
WAP00375405OtherRAILROAD MEDICARE
WAP00375405OtherRAILROAD MEDICARE