Kyle Gwinner Od Llc | |
801 E 3rd St, Ellsworth, KS 67439-0339 | |
(785) 472-3272 | |
(785) 472-3360 |
Full Name | Kyle Gwinner Od Llc |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 801 E 3rd St, Ellsworth, Kansas |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1609918523 | NPI | - | NPPES |
100090550D | Medicaid | KS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Primary |
Provider Name | Grant Kyle Gwinner |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1083055651 PECOS PAC ID: 4284852161 Enrollment ID: I20140908000864 |
Mailing Address | Practice Location Address |
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Kyle Gwinner Od Llc Po Box 339, Ellsworth, KS 67439-0339 Ph: (785) 472-3272 | Kyle Gwinner Od Llc 801 E 3rd St, Ellsworth, KS 67439-0339 Ph: (785) 472-3272 |
Dr. Grant Derril Gwinner, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 801 E 3rd St, Ellsworth, KS 67439 Phone: 785-472-3272 Fax: 785-472-3360 | |
Dr. Grant K Gwinner, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 801 E 3rd St, Suite A, Ellsworth, KS 67439 Phone: 785-472-3272 Fax: 785-472-3360 | |
G Derril Gwinner Od Llc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 801 E 3rd St, Ellsworth, KS 67439 Phone: 785-472-3272 Fax: 785-472-3360 |