| Doctor Name: | STEPHEN J VANDYKE |
| NPI Number: | 1003923012 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | OD |
| License Number: | 1839 |
| Business Practice Address: | 1611 Anne St Nw Bemidji, MN - 566015114 |
| Business Phone Number: | 2183332020 |
| Business Fax Number: | 2183332019 |
| Mailing Address: | 1611 Anne St Nw, BEMIDJI |
| State: | MN |
| Postal Code: | 566015114 |
| Phone Number: | 2183332020 |
| Fax Number: | 2183332019 |
| NPI Enumeration Date: | 08/24/2006 |
| NPI Last Update Date: | 12/16/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 152WC0802X |
| License Number: | 1839 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Optometrist |
| Taxonomy Specialization: | Corneal and Contact Management |
| Taxonomy Definition: | The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea |