Dr Daniel Carl Pridemore, OD | |
2761 S 108th St, West Allis, WI 53227-3232 | |
(414) 321-2425 | |
(414) 321-4647 |
Full Name | Dr Daniel Carl Pridemore |
---|---|
Gender | Male |
Speciality | Optometrist |
Location | 2761 S 108th St, West Allis, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1104189877 | NPI | - | NPPES |
020677066 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 3270-35 (Wisconsin) | Primary |
Provider Name | Froedtert &the Medical College Of Wisconsin Community Physicians Inc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1568787448 PECOS PAC ID: 3678760063 Enrollment ID: O20101210000699 |
Provider Name | Visionworks Inc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1154699445 PECOS PAC ID: 4385639616 Enrollment ID: O20120517000227 |
Mailing Address | Practice Location Address |
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Dr Daniel Carl Pridemore, OD 2761 S 108th St, West Allis, WI 53227-3232 Ph: () - | Dr Daniel Carl Pridemore, OD 2761 S 108th St, West Allis, WI 53227-3232 Ph: (414) 321-2425 |
John Laczkowski, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 2761 S 108th St, West Allis, WI 53227 Phone: 414-321-2425 Fax: 414-321-4647 | |
Dr. Jeffery A Braun, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 555 S 108th St, West Allis, WI 53214 Phone: 414-566-3803 Fax: 414-566-3866 | |
Sara C Falter, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 555 S 108th St, West Allis, WI 53214 Phone: 414-566-3050 | |
Dr. Sunya Masood, OD Optometrist Medicare: Medicare Enrolled Practice Location: 2761 S 108th St, West Allis, WI 53227 Phone: 414-321-2425 | |
Dr. David L Waterfill, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1401 S 108th St, West Allis, WI 53214 Phone: 414-476-0200 Fax: 414-476-1199 | |
Knight Vision & Glaucoma Specialists, Inc. Optometrist Medicare: Medicare Enrolled Practice Location: 7300 W Greenfield Ave, West Allis, WI 53214 Phone: 414-453-6667 Fax: 414-774-5505 |