| |
520 N Greenwood St., Shoshone, ID 83352 | |
(208) 537-2020 | |
(208) 537-2010 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 520 N Greenwood St., Shoshone, Idaho |
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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1851740716 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Primary |
Provider Name | Matthew E Kent |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1487648952 PECOS PAC ID: 5597795609 Enrollment ID: I20050818000384 |
Mailing Address | Practice Location Address |
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520 N Greenwood St., Shoshone, ID 83352 Ph: (208) 537-2020 | 520 N Greenwood St., Shoshone, ID 83352 Ph: (208) 537-2020 |
Dr. Matthew E. Kent, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 520 N Greenwood Street, Shoshone, ID 83352 Phone: 208-537-2020 Fax: 208-537-2010 |