| |
20 S Broadway, Pelican Rapids, MN 56572-0474 | |
(218) 863-7061 | |
(218) 863-7062 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 20 S Broadway, Pelican Rapids, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1457465296 | NPI | - | NPPES |
389558100 | Medicaid | MN | |
541525000 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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652 Jefferson Street N, Wadena, MN 56482-2307 Ph: (218) 631-1456 | 20 S Broadway, Pelican Rapids, MN 56572-0474 Ph: (218) 863-7061 |
Dr. Jeffrey Lee Mackner, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 20 South Broadway, Pelican Rapids, MN 56572 Phone: 218-863-7061 Fax: 218-863-7062 |