| Aspen Ridge Eye Care, Pllc | |
|
3456 E 17th St, Suite 150, Ammon, ID 83406-6757 | |
| (208) 528-6900 | |
| (208) 528-6904 |
| Full Name | Aspen Ridge Eye Care, Pllc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 3456 E 17th St, Ammon, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023223187 | NPI | - | NPPES |
| 807648800 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | ODP-100104 (Idaho) | Primary |
| Provider Name | Jerry D Carlson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1982651287 PECOS PAC ID: 8921089830 Enrollment ID: I20070724000798 |
| Mailing Address | Practice Location Address |
|---|---|
| Aspen Ridge Eye Care, Pllc 3456 E 17th St, Suite 150, Ammon, ID 83406-6757 Ph: (208) 528-6900 | Aspen Ridge Eye Care, Pllc 3456 E 17th St, Suite 150, Ammon, ID 83406-6757 Ph: (208) 528-6900 |
Dr. Daniel Glenn Nielson, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1536 Midway Dr, Ammon, ID 83406 Phone: 208-227-8822 | |
Dr. Joshua G Davis, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1201 S 25th E, Ammon, ID 83406 Phone: 208-524-8978 | |
Carl L. Giauque, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1201 S 25th E, Ammon, ID 83406 Phone: 208-524-8978 Fax: 208-524-8980 | |
National Vision Inc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 3421 South 25th Street East, Ammon, ID 83406 Phone: 986-497-6251 | |
Frederick G. Downard, O.d., P.a. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1990 Sabin Dr, Ammon, ID 83406 Phone: 208-522-6933 | |
Dr. Aaron Taylor, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 3421 South 25th Street East, Ammon, ID 83406 Phone: 986-497-6251 |