Fountain Optometry, P.c. | |
7 E Main St, Milan, MI 48160-1248 | |
(734) 439-2020 | |
(734) 439-2047 |
Full Name | Fountain Optometry, P.c. |
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Type | Facility |
Speciality | Optometrist |
Location | 7 E Main St, Milan, Michigan |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1003991183 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 4901004264 (Michigan) | Primary |
Provider Name | Kevin M Fountain |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1376563775 PECOS PAC ID: 1052319399 Enrollment ID: I20061120000472 |
Provider Name | Jaclyn Michelle Goodvin |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1467078915 PECOS PAC ID: 4789000613 Enrollment ID: I20200821001828 |
Mailing Address | Practice Location Address |
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Fountain Optometry, P.c. 7 E Main St, Milan, MI 48160-1248 Ph: (734) 439-2020 | Fountain Optometry, P.c. 7 E Main St, Milan, MI 48160-1248 Ph: (734) 439-2020 |
Dr. Kevin Michael Fountain, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 7 E Main St, Milan, MI 48160 Phone: 734-439-2020 Fax: 734-439-2047 | |
Jaclyn Goodvin, OD Optometrist Medicare: May Accept Medicare Assignments Practice Location: 7 E Main St, Milan, MI 48160 Phone: 734-439-2020 Fax: 734-439-2047 |