Dr Keith Lyston, OD | |
3300 Godfrey Rd, Godfrey, IL 62035-2558 | |
(618) 466-8787 | |
(618) 466-4703 |
Full Name | Dr Keith Lyston |
---|---|
Gender | Male |
Speciality | Optometry |
Experience | 32 Years |
Location | 3300 Godfrey Rd, Godfrey, Illinois |
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 |
---|---|---|---|
1861614810 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | TO3050 (Missouri) | Secondary |
152W00000X | Optometrist | 046008572 (Illinois) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Rose Optical, Inc. | 2961586805 | 4 |
Provider Name | Rose Optical, Inc. |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1669444063 PECOS PAC ID: 2961586805 Enrollment ID: O20080229000685 |
Mailing Address | Practice Location Address |
---|---|
Dr Keith Lyston, OD 3300 Godfrey Rd, Godfrey, IL 62035-2558 Ph: (618) 466-8787 | Dr Keith Lyston, OD 3300 Godfrey Rd, Godfrey, IL 62035-2558 Ph: (618) 466-8787 |
Bradley D Martinson, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 3300 Godfrey Rd, Godfrey, IL 62035 Phone: 618-466-8787 Fax: 618-466-4703 | |
Adeyinka A Adewale, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 3300 Godfrey Rd, Godfrey, IL 62035 Phone: 618-466-8787 Fax: 618-466-4703 | |
Dr. Mark Edward Ferguson, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 3300 Godfrey Rd, Godfrey, IL 62035 Phone: 618-466-8787 Fax: 618-466-4703 | |
Rose Optical, Inc. Optometrist Medicare: Medicare Enrolled Practice Location: 3300 Godfrey Rd, Godfrey, IL 62035 Phone: 618-466-8787 Fax: 618-466-4703 | |
Andrew Ibisch, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1310 Dadrian Prof Park, Godfrey, IL 62035 Phone: 618-433-5005 Fax: 618-467-1053 | |
Ron Loflin, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 3300 Godfrey Rd, Godfrey, IL 62035 Phone: 618-466-8787 | |
Illini Optometric Pc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 3300 Godfrey Rd, Godfrey, IL 62035 Phone: 618-466-8787 Fax: 618-466-4703 |