Drew C Dayton Chartered | |
622 E. Main St., Middleton, ID 83644-5502 | |
(208) 585-9500 | |
(208) 585-9497 |
Full Name | Drew C Dayton Chartered |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 622 E. Main St., Middleton, Idaho |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1407984925 | NPI | - | NPPES |
807484800 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | ODP-823 (Idaho) | Primary |
Provider Name | Joy G Johnson |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1659324960 PECOS PAC ID: 6002859238 Enrollment ID: I20050608000317 |
Provider Name | Lindsey C Warner |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1023786555 PECOS PAC ID: 9335537505 Enrollment ID: I20211021001251 |
Mailing Address | Practice Location Address |
---|---|
Drew C Dayton Chartered 622 E. Main St., Middleton, ID 83644-5502 Ph: (208) 585-9500 | Drew C Dayton Chartered 622 E. Main St., Middleton, ID 83644-5502 Ph: (208) 585-9500 |
Lindsey C Warner, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 622 E Main St, Middleton, ID 83644 Phone: 208-585-9500 Fax: 208-585-9497 | |
Steven O Davis, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 622 E Main St, Middleton, ID 83644 Phone: 208-585-9500 Fax: 208-585-9497 |