| Hayden Vision Source Pllc | |
|
8445 N Government Way, Hayden, ID 83835-9349 | |
| (208) 772-3208 | |
| (208) 762-2574 |
| Full Name | Hayden Vision Source Pllc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 8445 N Government Way, Hayden, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548999840 | NPI | - | NPPES |
| 1780345264 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| Provider Name | Robert Sorensen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1356335897 PECOS PAC ID: 9537200407 Enrollment ID: I20100120000231 |
| Provider Name | Tyrel J Bruneel |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1013575851 PECOS PAC ID: 1557695061 Enrollment ID: I20190702002802 |
| Provider Name | Anna Harding |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1295187458 PECOS PAC ID: 4688960552 Enrollment ID: I20200407001728 |
| Provider Name | Jett Scrimsher |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1912524513 PECOS PAC ID: 9739599721 Enrollment ID: I20201103000456 |
| Provider Name | Brian P Finley |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1649571118 PECOS PAC ID: 8325272495 Enrollment ID: I20221028002591 |
| Mailing Address | Practice Location Address |
|---|---|
| Hayden Vision Source Pllc 8445 N Government Way, Hayden, ID 83835-9349 Ph: (208) 772-3208 | Hayden Vision Source Pllc 8445 N Government Way, Hayden, ID 83835-9349 Ph: (208) 772-3208 |
Tyrel J Bruneel, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 8445 N Government Way, Hayden, ID 83835 Phone: 208-772-3208 Fax: 208-762-2574 | |
Dr. Danielle Rae Johnson, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 8220 N Cornerstone Dr Ste A, Hayden, ID 83835 Phone: 208-772-5539 | |
Eyeguys Optical Optometrist Medicare: Medicare Enrolled Practice Location: 8160 N. Cornerstone Ave., Suite B, Hayden, ID 83835 Phone: 208-772-5539 Fax: 208-772-9382 | |
Dr. Robert A Sorensen, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 8445 N Government Way, Hayden, ID 83835 Phone: 208-772-3208 Fax: 208-762-2574 | |
Dr. Daniel Leo Adams, DO Optometrist Medicare: Accepting Medicare Assignments Practice Location: 8220 N Cornerstone Dr Ste A, Hayden, ID 83835 Phone: 208-772-5539 | |
Kyle Andrew Stott, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 8445 N Government Way, Hayden, ID 83835 Phone: 208-772-3208 Fax: 208-762-2574 |