Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Medical Village Optical Shoppe Inc

Organization Optometrist · NPI 1073572962

Medical Village Optical Shoppe Inc is an Optometrist in Beverly Hills, Michigan. Licensed in Michigan. Registered with an NPI since 2006.

Licensed in
MI
In the registry since
2006
Specialties on file
3
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

31815 Southfield Rd Ste 12
Beverly Hills, MI 48025-5471
Phone: (248) 645-2220
Fax: (877) 547-8277
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 4901002468 (MI)
Optician Taxonomy 156FX1800X
Ophthalmology Physician Taxonomy 207W00000X

Record details

NPI number1073572962
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Roy Knoerr — Ceo · (248) 645-2220
Other names Medical Village Optical
NPI enumeratedMarch 21, 2006
Last updated in NPPESMay 17, 2016
Mailing address31815 Southfield Rd, Suite 12, Beverly Hills, MI 48025-5471

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