Mattax Neu Prater Eye Center, Inc. | |
430 N Jefferson Ave, Lebanon, MO 65536-2742 | |
(417) 886-3937 | |
(417) 886-1285 |
Full Name | Mattax Neu Prater Eye Center, Inc. |
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Type | Facility |
Speciality | Ophthalmology |
Location | 430 N Jefferson Ave, Lebanon, Missouri |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1528163300 | NPI | - | NPPES |
CI7182 | Other | MO | RAILROAD MEDICARE PART B |
505886200 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Provider Name | Marla C Smith |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1093776098 PECOS PAC ID: 9234267295 Enrollment ID: I20100512000477 |
Provider Name | Michael S Engleman |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1790754109 PECOS PAC ID: 2062540032 Enrollment ID: I20100512000611 |
Provider Name | Leo T Neu |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1588632889 PECOS PAC ID: 0143325050 Enrollment ID: I20100512000782 |
Provider Name | Thomas G Prater |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1043289119 PECOS PAC ID: 1052416963 Enrollment ID: I20100512000855 |
Provider Name | Matthew T Smith |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1548239163 PECOS PAC ID: 6608904610 Enrollment ID: I20100512000937 |
Provider Name | James B Mattax |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1346244779 PECOS PAC ID: 5597652370 Enrollment ID: I20100512000973 |
Provider Name | Jacob K Thomas |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1538328489 PECOS PAC ID: 6305016775 Enrollment ID: I20120725000343 |
Provider Name | Benjamin P Haden |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1952729600 PECOS PAC ID: 5991020950 Enrollment ID: I20180809006027 |
Provider Name | David A Nasrazadani |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1922529536 PECOS PAC ID: 0547522310 Enrollment ID: I20220920001077 |
Provider Name | Drew A Young |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1407411093 PECOS PAC ID: 6305207515 Enrollment ID: I20230804000393 |
Mailing Address | Practice Location Address |
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Mattax Neu Prater Eye Center, Inc. 1265 E Primrose St, Springfield, MO 65804-4278 Ph: (417) 886-3937 | Mattax Neu Prater Eye Center, Inc. 430 N Jefferson Ave, Lebanon, MO 65536-2742 Ph: (417) 886-3937 |