| |
16410 Third Street, Suite A, La Pine, OR 97739-0000 | |
(541) 536-2911 | |
(541) 536-2913 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 16410 Third Street, La Pine, Oregon |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1881828135 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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152W00000X | Optometrist | 3178ATI (Oregon) | Primary |
Provider Name | Graham A Balcer |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1851310528 PECOS PAC ID: 4284639907 Enrollment ID: I20061002000089 |
Provider Name | Etosha C Fegan |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1275996894 PECOS PAC ID: 4981962131 Enrollment ID: I20171218002011 |
Mailing Address | Practice Location Address |
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Po Box 3120, La Pine, OR 97739-3120 Ph: (541) 536-2911 | 16410 Third Street, Suite A, La Pine, OR 97739-0000 Ph: (541) 536-2911 |
Dr. Graham Aron Balcer, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 51530 Huntington Rd, Suite #1, La Pine, OR 97739 Phone: 541-536-2911 Fax: 541-536-2913 |