| Kootenai Vision Center | |
|
1801 N Third St, Coeur D Alene, ID 83814 | |
| (208) 667-1591 | |
| (208) 676-8574 |
| Full Name | Kootenai Vision Center |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 1801 N Third St, Coeur D Alene, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386856284 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | ODP1029 (Idaho) | Primary |
| Provider Name | Lance W Fagan |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1891775151 PECOS PAC ID: 6305884917 Enrollment ID: I20050422000620 |
| Provider Name | Robert John Johnson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1265484604 PECOS PAC ID: 7416057856 Enrollment ID: I20070713000382 |
| Provider Name | Jared Lambert |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1548944275 PECOS PAC ID: 0345695052 Enrollment ID: I20231016003238 |
| Mailing Address | Practice Location Address |
|---|---|
| Kootenai Vision Center 1801 N Third St, Coeur D Alene, ID 83814 Ph: (208) 667-1591 | Kootenai Vision Center 1801 N Third St, Coeur D Alene, ID 83814 Ph: (208) 667-1591 |
Empire Eye Physicians Optometrist Medicare: Medicare Enrolled Practice Location: 2175 N Main St, Coeur D Alene, ID 83814 Phone: 208-664-9888 Fax: 208-666-0816 | |
Roy Lavern Clapper, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 355 E Neider Ave, Coeur D Alene, ID 83815 Phone: 208-676-7356 Fax: 208-676-7384 | |
Dr. Cindy L Ellenbecker, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1250 W Ironwood Dr, Coeur D Alene, ID 83814 Phone: 208-667-2255 Fax: 208-765-5889 | |
Kelsi Butherus, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 355 E Neider Ave, Coeur D Alene, ID 83815 Phone: 208-676-7356 | |
Coeur D Alene Eye Care Optometrist Medicare: Not Enrolled in Medicare Practice Location: 409 W Neider Ave Ste C, Coeur D Alene, ID 83815 Phone: 208-765-5665 Fax: 208-765-1716 | |
Ellenbecker Eye Clinic, Pllc Optometrist Medicare: Medicare Enrolled Practice Location: 1250 W Ironwood Dr, Suite 201, Coeur D Alene, ID 83814 Phone: 208-667-2255 Fax: 208-765-5889 | |
Dr. Robert John Johnson, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1801 N 3rd St, Coeur D Alene, ID 83814 Phone: 208-667-1591 Fax: 208-676-8574 |