| Full Name | |
|---|---|
| Type | Facility |
| Speciality | Optometrist - Vision Therapy |
| Location | 123 Locust St, Allegan, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366643538 | NPI | - | NPPES |
| 900Z310140 | Other | BCBS OF MICHIGAN | |
| 944193774 | Medicaid | MI | |
| 944340860 | Medicaid | MI |
| Provider Name | Paul Hodge |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1861498974 PECOS PAC ID: 0840306015 Enrollment ID: I20110413000541 |
| Provider Name | Amanda M Hodge |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1548558935 PECOS PAC ID: 8325212491 Enrollment ID: I20111130000103 |
| Provider Name | Matthew Austin |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1922591957 PECOS PAC ID: 5496000184 Enrollment ID: I20180620003388 |
| Provider Name | Emily Herendeen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1760189476 PECOS PAC ID: 0345696068 Enrollment ID: I20231031003145 |
| Mailing Address | Practice Location Address |
|---|---|
123 Locust St, Allegan, MI 49010 Ph: (269) 673-5100 | 123 Locust St, Allegan, MI 49010 Ph: (269) 673-5100 |
Dr. Dale L Wittkop, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 123 Locust St, Allegan, MI 49010 Phone: 269-673-5100 Fax: 269-673-1806 | |
Dr. Amanda M Hodge, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 123 Locust St, Allegan, MI 49010 Phone: 269-673-5100 Fax: 269-673-1806 | |
Dr. Paul Anton Hodge, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 123 Locust St, Allegan, MI 49010 Phone: 269-673-5100 Fax: 269-673-1806 |