Ethan Ranger Taylor, OD | |
824 Stillwater Avenue, Bangor, ME 04401-3614 | |
(207) 847-7554 | |
Not Available |
Full Name | Ethan Ranger Taylor |
---|---|
Gender | Male |
Speciality | Optometry |
Experience | 10 Years |
Location | 824 Stillwater Avenue, Bangor, Maine |
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 |
---|---|---|---|
1306272406 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | OPT949 (Maine) | Primary |
152W00000X | Optometrist | 3398 (Minnesota) | Secondary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Smart Vision Llc | 8022393230 | 7 |
Provider Name | Smart Vision Llc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1043394885 PECOS PAC ID: 8022393230 Enrollment ID: O20170329002600 |
Mailing Address | Practice Location Address |
---|---|
Ethan Ranger Taylor, OD 824 Stillwater Avenue, Bangor, ME 04401-3614 Ph: (207) 847-7554 | Ethan Ranger Taylor, OD 824 Stillwater Avenue, Bangor, ME 04401-3614 Ph: (207) 847-7554 |
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