Brant Michael Southam, OD | |
3201 Lakeside Dr, Reno, NV 89509 | |
(775) 825-0559 | |
(775) 829-7918 |
Full Name | Brant Michael Southam |
---|---|
Gender | Male |
Speciality | Optometry |
Experience | 15 Years |
Location | 3201 Lakeside Dr, Reno, Nevada |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1831427160 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | OD60235215 (Washington) | Secondary |
152W00000X | Optometrist | 1727 (Arizona) | Secondary |
152W00000X | Optometrist | 779 (Nevada) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
B. Michael Southam, Od, Pc | 7911138417 | 2 |
Provider Name | B. Michael Southam, Od, Pc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1235550146 PECOS PAC ID: 7911138417 Enrollment ID: O20140326001695 |
Mailing Address | Practice Location Address |
---|---|
Brant Michael Southam, OD 3201 Lakeside Dr, Reno, NV 89509-4830 Ph: (775) 825-0559 | Brant Michael Southam, OD 3201 Lakeside Dr, Reno, NV 89509 Ph: (775) 825-0559 |
Jeffrey D. Ferris, O.d., P.c. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 5595 S. Virginia St., Suite B, Reno, NV 89502 Phone: 775-828-2300 | |
Dr. Richard Andrew Boren, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 6360 Mae Anne Ave., Suite 1, Reno, NV 89523 Phone: 772-787-9137 Fax: 775-323-3652 | |
Dr. Troy Robert Ogden, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 236 W. 6th St, Suite 100, Reno, NV 89503 Phone: 775-322-4061 Fax: 775-322-6603 | |
Family Eyecare Associates Optometrist Medicare: Not Enrolled in Medicare Practice Location: 18601 Wedge Pkwy, Reno, NV 89511 Phone: 775-358-1020 | |
Kopolow & Girisgen Od Pc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 13921 S Virginia St Ste 116, Reno, NV 89511 Phone: 702-341-7254 | |
Optic Gallery South Meadows Llc Optometrist Medicare: Medicare Enrolled Practice Location: 770 S Meadows Pkwy Ste 108&109, Reno, NV 89521 Phone: 775-224-4543 | |
Dr. David Hubbard, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 10459 Double R Blvd, Reno, NV 89521 Phone: 775-827-3030 Fax: 775-827-5479 |