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14088 Alabama St, Jay, FL 32565-1036 | |
(850) 675-0625 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 14088 Alabama St, Jay, Florida |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1003090556 | NPI | - | NPPES |
621048100 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
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152W00000X | Optometrist | OPC3531 (Florida) | Primary |
Provider Name | Gregory D Heaton |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1588605059 PECOS PAC ID: 1557389053 Enrollment ID: I20051103000255 |
Mailing Address | Practice Location Address |
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Po Box 25, Jay, FL 32565-0025 Ph: (850) 675-0625 | 14088 Alabama St, Jay, FL 32565-1036 Ph: (850) 675-0625 |
Mr. Gregory D Heaton, OD PA Optometrist Medicare: Accepting Medicare Assignments Practice Location: 14088 Alabama St, Jay, FL 32565 Phone: 850-675-0625 Fax: 850-675-3921 |