Aeg Louisiana Professional Pc | |
111 E 4th St Ste 440, Alton, IL 62002-6206 | |
(618) 462-9818 | |
(314) 741-4947 |
Full Name | Aeg Louisiana Professional Pc |
---|---|
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 |
---|---|---|---|
1629827795 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Primary |
Provider Name | Adam M Paddock |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1598827099 PECOS PAC ID: 2860396496 Enrollment ID: I20031125000041 |
Provider Name | Richard H Bond |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1396742698 PECOS PAC ID: 1355327602 Enrollment ID: I20040628000776 |
Provider Name | Christopher Wroten |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1902919913 PECOS PAC ID: 4789628660 Enrollment ID: I20050613000025 |
Provider Name | Catherine Lea Johnson |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1003225921 PECOS PAC ID: 8325269525 Enrollment ID: I20141030002355 |
Mailing Address | Practice Location Address |
---|---|
Aeg Louisiana Professional Pc 111 E 4th St Ste 440, Alton, IL 62002-6206 Ph: (618) 462-9818 | Aeg Louisiana Professional Pc 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 | |