Dr Jackson Riley Fitzgerald, OD | |
50 E 4th Ave, Afton, WY 83110-5027 | |
(307) 885-3975 | |
Not Available |
Full Name | Dr Jackson Riley Fitzgerald |
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Gender | Male |
Speciality | Optometrist |
Location | 50 E 4th Ave, Afton, Wyoming |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1598495384 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 548T (Wyoming) | Secondary |
152W00000X | Optometrist | OPT-OPT-LIC-4481 (Montana) | Primary |
Provider Name | Watson Hayes Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1588123590 PECOS PAC ID: 4486089133 Enrollment ID: O20210322002166 |
Mailing Address | Practice Location Address |
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Dr Jackson Riley Fitzgerald, OD 4 S Hillside Dr, Elk Ridge, UT 84651-8501 Ph: (801) 669-3687 | Dr Jackson Riley Fitzgerald, OD 50 E 4th Ave, Afton, WY 83110-5027 Ph: (307) 885-3975 |
Dr. James Edward Moser, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 50 East 4th Ave., Afton, WY 83110 Phone: 307-885-3975 | |
Voss Vision, Llc Optometrist Medicare: Medicare Enrolled Practice Location: 50 East 4th Ave., Afton, WY 83110 Phone: 307-885-3975 | |
Jenning Voss, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 50e 4th Ave, Afton, WY 83110 Phone: 307-885-3975 Fax: 307-885-9612 | |
Dr. Brittany Luksich, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 50 E 4th Ave, Afton, WY 83110 Phone: 307-885-3975 |