Eye Clinic Of Fairbanks, Inc | |
116 Minnie St, Fairbanks, AK 99701-3006 | |
(907) 456-7760 | |
(907) 451-7916 |
Full Name | Eye Clinic Of Fairbanks, Inc |
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Type | Facility |
Speciality | Ophthalmology |
Location | 116 Minnie St, Fairbanks, Alaska |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1689903965 | NPI | - | NPPES |
A0330 | Other | AK | BLUE CROSS |
MDG576 | Medicaid | AK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 292621 (Alaska) | Secondary |
156FX1800X | Technician/technologist - Optician | 292621 (Alaska) | Secondary |
207W00000X | Ophthalmology | 292621 (Alaska) | Primary |
Provider Name | Ronald W Zamber |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1831177187 PECOS PAC ID: 8325053762 Enrollment ID: I20101006000759 |
Provider Name | Larry Coon |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1881673853 PECOS PAC ID: 1759573967 Enrollment ID: I20101006000806 |
Provider Name | Damien R Delzer |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1346228517 PECOS PAC ID: 6204028434 Enrollment ID: I20101006001089 |
Provider Name | Natalie E Macke |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1487921748 PECOS PAC ID: 5890961452 Enrollment ID: I20120103000208 |
Provider Name | David J Peterson |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1164411930 PECOS PAC ID: 4688895048 Enrollment ID: I20141028002050 |
Provider Name | Stanley R Fuller |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1396034658 PECOS PAC ID: 8325355167 Enrollment ID: I20150911000561 |
Provider Name | Jeremy Cole Fulk |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1134571698 PECOS PAC ID: 0941595888 Enrollment ID: I20160817000881 |
Provider Name | Rebecca S Wilbur |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1619427150 PECOS PAC ID: 7315227857 Enrollment ID: I20191115002619 |
Provider Name | Laura E Langford |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1851821615 PECOS PAC ID: 9739441262 Enrollment ID: I20201007001800 |
Provider Name | Terry David Bell |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1841807062 PECOS PAC ID: 8729408596 Enrollment ID: I20201015002662 |
Mailing Address | Practice Location Address |
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Eye Clinic Of Fairbanks, Inc 116 Minnie St, Fairbanks, AK 99701-3006 Ph: (907) 456-7760 | Eye Clinic Of Fairbanks, Inc 116 Minnie St, Fairbanks, AK 99701-3006 Ph: (907) 456-7760 |