| Drs. Roush & Will Optometrists Inc | |
|
781 E. North St, Kendallville, IN 46755-1225 | |
| (260) 347-3611 | |
| (260) 347-4425 |
| Full Name | Drs. Roush & Will Optometrists Inc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 781 E. North St, Kendallville, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578613295 | NPI | - | NPPES |
| 100355140B | Medicaid | IN | |
| 100355140C | Medicaid | IN | |
| 100355140A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| 332H00000X | Eyewear Supplier | 0921390001 (Indiana) | Secondary |
| Provider Name | Matthew Will |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1710982475 PECOS PAC ID: 1355319815 Enrollment ID: I20040922000488 |
| Provider Name | Craig A Bonham |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1578525341 PECOS PAC ID: 1153425368 Enrollment ID: I20070328000320 |
| Provider Name | Robert Alan Roush |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003811860 PECOS PAC ID: 8820064017 Enrollment ID: I20091228000547 |
| Provider Name | Elizabeth Jane Roush |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1336451640 PECOS PAC ID: 1456485002 Enrollment ID: I20100817001716 |
| Provider Name | Craig Michael Lichlyter |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1720392020 PECOS PAC ID: 2466644679 Enrollment ID: I20101006000832 |
| Mailing Address | Practice Location Address |
|---|---|
| Drs. Roush & Will Optometrists Inc 781 E. North St, Kendallville, IN 46755-1225 Ph: (260) 347-3611 | Drs. Roush & Will Optometrists Inc 781 E. North St, Kendallville, IN 46755-1225 Ph: (260) 347-3611 |
Robert Alan Roush, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 781 E North Street, Kendallville, IN 46755 Phone: 260-347-3458 Fax: 260-347-4425 | |
Rx Optical Optometrist Medicare: Not Enrolled in Medicare Practice Location: 208 W North St, Kendallville, IN 46755 Phone: 260-349-1008 Fax: 260-349-0549 | |
Elizabeth Jane Roush, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 781 E North St, Kendallville, IN 46755 Phone: 260-347-3458 Fax: 260-347-4425 | |
Dr. Matthew S Will, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 781 E North Street, Kendallville, IN 46755 Phone: 260-347-3458 Fax: 260-347-4425 | |
Craig Michael Lichlyter, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 781 E North St, Kendallville, IN 46755 Phone: 260-347-3458 Fax: 260-347-4425 | |
Rx Optical Laboratories, Inc. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 208 W North St, Kendallville, IN 46755 Phone: 260-349-1008 |