Dr Brent Ryan Davidson, MD | |
1011 Bowles Ave, Suite 415, Fenton, MO 63026-2395 | |
(636) 717-1700 | |
(636) 203-4727 |
Full Name | Dr Brent Ryan Davidson |
---|---|
Gender | Male |
Speciality | Ophthalmology |
Experience | 23 Years |
Location | 1011 Bowles Ave, Fenton, Missouri |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1437127065 | NPI | - | NPPES |
10032015 | Other | IL | BLUECROSS BLUESHIELD |
P00339415 | Other | IL | RAILROAD MEDICARE |
714579 | Other | HEALTHLINK | |
714579 | Other | IL | HEALTHLINK |
109208 | Other | MO | HEALTH ALLIANCE |
P00238356 | Other | MO | RAILROAD MEDICARE |
113109 | Other | IL | HEALTH ALLIANCE |
226523 | Other | MO | GROUP HEALTH PLAN |
207319807 | Medicaid | MO | |
5617586 | Other | MO | FIRST HEALTH |
753168118 | Other | UNITED HEALTHCARE | |
199422 | Other | MO | BLUE CROSS BLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207W00000X | Ophthalmology | 2005009915 (Missouri) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Parkland Health Center | Farmington, MO | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Envision Eye Specialists Pc | 0042375941 | 5 |
Entity Name | Envision Eye Specialists Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1205072360 PECOS PAC ID: 0042375941 Enrollment ID: O20090210000052 |
Mailing Address | Practice Location Address |
---|---|
Dr Brent Ryan Davidson, MD 1011 Bowles Ave, Suite 200, Fenton, MO 63026-2395 Ph: (636) 717-1700 | Dr Brent Ryan Davidson, MD 1011 Bowles Ave, Suite 415, Fenton, MO 63026-2395 Ph: (636) 717-1700 |
Shana Widick Rose, M.D. Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 1011 Bowles Ave, Suite 415, Fenton, MO 63026 Phone: 636-717-1700 Fax: 636-203-4727 | |
Dr. Andrew Jacob Polk, MD Ophthalmology Medicare: Medicare Enrolled Practice Location: 1011 Bowles Ave Ste 200, Fenton, MO 63026 Phone: 636-717-1700 Fax: 636-203-4727 |