Kathryn Elizabeth Fenton, OD | |
151 W Main St, Wilmington, OH 45177-2238 | |
(937) 382-6643 | |
(937) 382-6644 |
Full Name | Kathryn Elizabeth Fenton |
---|---|
Gender | Female |
Speciality | Optometrist |
Location | 151 W Main St, Wilmington, Ohio |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1447229620 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | OH4190/T1094 (Ohio) | Primary |
Provider Name | Cooke Landen & Grutzmacher Od Inc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1154402493 PECOS PAC ID: 3577555614 Enrollment ID: O20040331000306 |
Mailing Address | Practice Location Address |
---|---|
Kathryn Elizabeth Fenton, OD 151 W Main St, Wilmington, OH 45177-2238 Ph: (937) 382-6643 | Kathryn Elizabeth Fenton, OD 151 W Main St, Wilmington, OH 45177-2238 Ph: (937) 382-6643 |
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