| Grand Teton Eye & Optical | |
|
110 Buffalo Way Ste A, Jackson, WY 83002-8460 | |
| (307) 733-4905 | |
| Not Available |
| Full Name | Grand Teton Eye & Optical |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 110 Buffalo Way Ste A, Jackson, Wyoming |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306983655 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | ODP-100010 (Idaho) | Primary |
| Provider Name | Chad L Roberts |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1295863504 PECOS PAC ID: 4688567167 Enrollment ID: I20040609000148 |
| Mailing Address | Practice Location Address |
|---|---|
| Grand Teton Eye & Optical Po Box 613, Victor, ID 83455-0613 Ph: (208) 787-2088 | Grand Teton Eye & Optical 110 Buffalo Way Ste A, Jackson, WY 83002-8460 Ph: (307) 733-4905 |
Dr. Chad Roberts, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 110 Buffalo Way, Ste A, Jackson, WY 83002 Phone: 307-733-4905 Fax: 307-733-4906 | |
Dr. Eliza Marguerite Whatley, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 80 W Broadway Ave Apt 104, Jackson, WY 83001 Phone: 307-733-1441 Fax: 307-734-8232 | |
Bonnie Christine Kovacs, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 555 E Broadway Ave Ste 214, Jackson, WY 83001 Phone: 307-733-1051 | |
Wyoming Eye Care Inc Pc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 110 Buffalo Way St A, Jackson, WY 83002 Phone: 307-733-4905 Fax: 307-733-4906 |