Provider Demographics
NPI:1053593715
Name:ROBERT C LAYMAN OD INC
Entity type:Organization
Organization Name:ROBERT C LAYMAN OD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:BENSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-854-3937
Mailing Address - Street 1:3309 QUAIL HOLLOW DR STE E
Mailing Address - Street 2:
Mailing Address - City:LAMBERTVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48144-8688
Mailing Address - Country:US
Mailing Address - Phone:734-854-3937
Mailing Address - Fax:734-854-5868
Practice Address - Street 1:3309 QUAIL HOLLOW DR STE E
Practice Address - Street 2:
Practice Address - City:LAMBERTVILLE
Practice Address - State:MI
Practice Address - Zip Code:48144-8688
Practice Address - Country:US
Practice Address - Phone:734-854-3937
Practice Address - Fax:734-854-5868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901002-861152W00000X
MI4901002-2861332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI941931252Medicaid
MI22-01112OtherUNITED HEALTH CARE
MI03157OtherPARAMOUNT
MI900E811650OtherBLUE CROSS BLUE SHIELD
MI03157OtherPARAMOUNT
MI900E811650OtherBLUE CROSS BLUE SHIELD
MI941931252Medicaid