| Gregory Clark, O.d., Inc. | |
|
12547 Riverdale Blvd Nw, Costco Optical Department, Coon Rapids, MN 55448-6708 | |
| (763) 712-7761 | |
| (763) 712-7787 |
| Full Name | Gregory Clark, O.d., Inc. |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 12547 Riverdale Blvd Nw, Coon Rapids, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801965504 | NPI | - | NPPES |
| 1634747-00 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 2806 (Minnesota) | Primary |
| Provider Name | Jason J Stensos |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1205844966 PECOS PAC ID: 8325078322 Enrollment ID: I20050819000023 |
| Provider Name | Gregory A Clark |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467521153 PECOS PAC ID: 8426153867 Enrollment ID: I20070413000410 |
| Mailing Address | Practice Location Address |
|---|---|
| Gregory Clark, O.d., Inc. 16160 22nd Pl N, Plymouth, MN 55447-2382 Ph: (612) 703-0298 | Gregory Clark, O.d., Inc. 12547 Riverdale Blvd Nw, Costco Optical Department, Coon Rapids, MN 55448-6708 Ph: (763) 712-7761 |
Dr. Kristi Jo Backer Palmer, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 9055 Springbrook Dr Nw, Coon Rapids, MN 55433 Phone: 763-780-9155 | |
Dr. Bridget C Axelson, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 3777 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433 Phone: 763-421-7420 | |
Robert Dodge, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 12737 Riverdale Blvd Nw, Coon Rapids, MN 55448 Phone: 763-433-3468 | |
Nordin Eye Care Associates Inc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 13020 Riverdale Dr Nw, Coon Rapids, MN 55448 Phone: 763-421-9652 | |
James Conrad Verkuilen, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 9055 Springbrook Dr Nw, Coon Rapids, MN 55433 Phone: 763-780-9155 | |
Vista Family Eye Care Llc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 9920 Foley Blvd Nw Ste 120, Coon Rapids, MN 55433 Phone: 763-843-7153 | |
Dr. Paul Chadima Hammond, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 3777 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433 Phone: 763-421-7420 |