Provider Demographics
NPI:1679611941
Name:MICHAEL K HARKINS & MARK A KARSTEN PTR
Entity type:Organization
Organization Name:MICHAEL K HARKINS & MARK A KARSTEN PTR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:K
Authorized Official - Last Name:HARKINS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:989-354-5890
Mailing Address - Street 1:PO BOX 158
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-0158
Mailing Address - Country:US
Mailing Address - Phone:989-354-5890
Mailing Address - Fax:989-365-6213
Practice Address - Street 1:224 E CHISHOLM ST STE A
Practice Address - Street 2:
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-2820
Practice Address - Country:US
Practice Address - Phone:989-354-5890
Practice Address - Fax:989-356-6213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMH002454152W00000X
MIMK002883152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMH002454OtherBLUE CROSS
MIMK002883OtherBLUE CROSS
MIMH002454OtherBLUE CROSS
MI0302590001Medicare NSC
MIT33896Medicare UPIN
MI0Z44509Medicare PIN