Hollingshead Eye Center, Pc | |
360 E Mallard Dr, Suite 110, Boise, ID 83706-6644 | |
(208) 336-8700 | |
(208) 426-0902 |
Full Name | Hollingshead Eye Center, Pc |
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Type | Facility |
Speciality | Ophthalmology |
Location | 360 E Mallard Dr, Boise, Idaho |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1871643585 | NPI | - | NPPES |
805858400 | Medicaid | ID | |
805858500 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | ODP100159 (Idaho) | Secondary |
207W00000X | Ophthalmology | M6436 (Idaho) | Primary |
Provider Name | Mark E Hollingshead |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1689670911 PECOS PAC ID: 4789628165 Enrollment ID: I20101222001004 |
Provider Name | Dylan Leon Hatfield |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1972813855 PECOS PAC ID: 2567779986 Enrollment ID: I20150917001991 |
Provider Name | Kacey D Blaylock |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1164871489 PECOS PAC ID: 2062705460 Enrollment ID: I20160722000745 |
Provider Name | Ryan Barrett |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1982994844 PECOS PAC ID: 9931420452 Enrollment ID: I20160912001778 |
Provider Name | Scott A Woolf |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1629509682 PECOS PAC ID: 3274913702 Enrollment ID: I20220630001040 |
Mailing Address | Practice Location Address |
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Hollingshead Eye Center, Pc 360 E Mallard Dr, Suite 110, Boise, ID 83706-6644 Ph: (208) 336-8700 | Hollingshead Eye Center, Pc 360 E Mallard Dr, Suite 110, Boise, ID 83706-6644 Ph: (208) 336-8700 |