| Idocs Of Dodge City, Pa | |
|
2520 N 14th Ave, Dodge City, KS 67801-2315 | |
| (620) 227-3071 | |
| (620) 227-6911 |
| Full Name | Idocs Of Dodge City, Pa |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 2520 N 14th Ave, Dodge City, Kansas |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588785786 | NPI | - | NPPES |
| 100090850A | Medicaid | KS | |
| 043311 | Other | KS | BCBS GROUP # |
| 200399790A | Medicaid | KS | |
| 100219900A | Medicaid | KS | |
| C57955 | Other | KS | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 1744 (Kansas) | Primary |
| Provider Name | Robert O Hatfield |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104922020 PECOS PAC ID: 3476592189 Enrollment ID: I20050502000511 |
| Provider Name | Jordan E Gwaltney |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1023124989 PECOS PAC ID: 1951306414 Enrollment ID: I20060916000015 |
| Provider Name | Melissa Nicole Cole |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1134659782 PECOS PAC ID: 1557639101 Enrollment ID: I20170622001932 |
| Provider Name | Trevor Ryan Brock |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1710559216 PECOS PAC ID: 9032512421 Enrollment ID: I20210722002123 |
| Provider Name | Caitlin Mary Lingg |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1477284768 PECOS PAC ID: 9032593991 Enrollment ID: I20220826002097 |
| Mailing Address | Practice Location Address |
|---|---|
| Idocs Of Dodge City, Pa 2520 N 14th Ave, Dodge City, KS 67801-2315 Ph: (620) 227-3071 | Idocs Of Dodge City, Pa 2520 N 14th Ave, Dodge City, KS 67801-2315 Ph: (620) 227-3071 |
Dr. Jordan E Gwaltney, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2520 N 14th Ave, Dodge City, KS 67801 Phone: 620-227-3071 Fax: 620-227-6911 | |
Dr. Thomas Lee Anderson, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2520 N 14th Ave, Dodge City, KS 67801 Phone: 620-227-3071 | |
Dr. Robert O Hatfield, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2520 N 14th Ave, Dodge City, KS 67801 Phone: 620-227-3071 Fax: 620-227-6911 | |
Dr. Melissa Nicole Cole, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2520 N 14th Ave, Dodge City, KS 67801 Phone: 620-227-3071 Fax: 620-227-6911 | |
Dr. Lois Ann Vierthaler Kessen, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 208 W Ross Blvd, Suite A, Dodge City, KS 67801 Phone: 620-225-6500 Fax: 620-225-6597 | |
Dr. David L Wolf, OD PA Optometrist Medicare: Not Enrolled in Medicare Practice Location: 2520 N 14th Ave, Dodge City, KS 67801 Phone: 620-227-3071 Fax: 620-227-6911 | |
Vierthaler Kessen Optometry, Llc Optometrist Medicare: Medicare Enrolled Practice Location: 208 W Ross Blvd, Suite A, Dodge City, KS 67801 Phone: 620-225-6500 Fax: 620-225-6597 |