| Aeg Kentucky Professional, Pllc | |
|
111 E 4th St Ste 440, Alton, IL 62002-6206 | |
| (618) 462-9818 | |
| (314) 741-4947 |
| Full Name | Aeg Kentucky Professional, Pllc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 111 E 4th St Ste 440, Alton, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467214080 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| Provider Name | Robert Alan Hamilton |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1669471843 PECOS PAC ID: 1658273594 Enrollment ID: I20040122000370 |
| Provider Name | Marty S Traylor |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1336108927 PECOS PAC ID: 5294627410 Enrollment ID: I20040325000045 |
| Provider Name | Davea A Horton |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1699734285 PECOS PAC ID: 1052341518 Enrollment ID: I20050816000114 |
| Provider Name | Steven H Shake |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1922068386 PECOS PAC ID: 2668363581 Enrollment ID: I20100616000876 |
| Provider Name | Elizabeth Mauzy Martin |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1083969034 PECOS PAC ID: 6709042146 Enrollment ID: I20120730000366 |
| Provider Name | Christopher Scott Meyer |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1710361159 PECOS PAC ID: 0840505459 Enrollment ID: I20150811005682 |
| Provider Name | Karlie Blain Hoelscher |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1669103032 PECOS PAC ID: 2860872090 Enrollment ID: I20220908002498 |
| Provider Name | Elizabeth Ann Richardson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1285310029 PECOS PAC ID: 3870955230 Enrollment ID: I20230816003333 |
| Provider Name | Kaitlin B Nesty |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1023888088 PECOS PAC ID: 3476905142 Enrollment ID: I20240227003271 |
| Mailing Address | Practice Location Address |
|---|---|
| Aeg Kentucky Professional, Pllc 111 E 4th St Ste 440, Alton, IL 62002-6206 Ph: (618) 462-9818 | Aeg Kentucky Professional, Pllc 111 E 4th St Ste 440, Alton, IL 62002-6206 Ph: (618) 462-9818 |
Aeg Delaware Professional Pa Optometrist Medicare: Medicare Enrolled Practice Location: 111 E 4th St Ste 440, Alton, IL 62002 Phone: 618-462-9818 | |
Aeg Connecticut Professional Pllc Optometrist Medicare: Medicare Enrolled Practice Location: 111 E 4th St Ste 440, Alton, IL 62002 Phone: 618-462-9818 Fax: 314-741-4947 | |
Dr. James Walter Lieber, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 401 Henry St, Alton, IL 62002 Phone: 618-465-6000 | |
Mark D. Wade O D P C Optometrist Medicare: Not Enrolled in Medicare Practice Location: 111 E 4th St Ste 440, Alton, IL 62002 Phone: 618-462-9818 Fax: 314-741-4947 | |