| Deboer Family Eyecare | |
|
609 N Halleck St, Demotte, IN 46310-9545 | |
| (219) 987-3673 | |
| Not Available |
| Full Name | Deboer Family Eyecare |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 609 N Halleck St, Demotte, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972513653 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 18002342 (Indiana) | Primary |
| Provider Name | John M Deboer |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1770566556 PECOS PAC ID: 0840229902 Enrollment ID: I20120201000663 |
| Provider Name | Brant T Molenaar |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1942307053 PECOS PAC ID: 9638362379 Enrollment ID: I20150211000187 |
| Mailing Address | Practice Location Address |
|---|---|
| Deboer Family Eyecare Po Box 849, 609 N. Halleck Street, Demotte, IN 46310-0849 Ph: (219) 987-3673 | Deboer Family Eyecare 609 N Halleck St, Demotte, IN 46310-9545 Ph: (219) 987-3673 |
Dr. John Mark Deboer, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 609 N Halleck St, Demotte, IN 46310 Phone: 219-987-3673 Fax: 219-987-3905 | |
De Boer Family Eyecare Optometrist Medicare: Not Enrolled in Medicare Practice Location: 609 N Halleck St, Demotte, IN 46310 Phone: 219-987-3673 Fax: 219-987-3905 | |
Dr. Gerrit H. Devries, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 609 N Halleck St, Demotte, IN 46310 Phone: 219-987-3673 Fax: 219-987-3905 |