Mr Mark A Latta, OD | |
Corner Of Route N12 And N7, Fort Defiance, AZ 86504 | |
(928) 729-8925 | |
Not Available |
Full Name | Mr Mark A Latta |
---|---|
Gender | Male |
Speciality | Optometrist |
Location | Corner Of Route N12 And N7, Fort Defiance, Arizona |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1609865872 | NPI | - | NPPES |
410039483 | Other | TX | RAILROAD MEDICARE |
89X292 | Other | TX | BC/BS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 2728TG (Texas) | Primary |
Provider Name | Dhhs Phs Naihs Shiprock Hospital |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1780639971 PECOS PAC ID: 0749193837 Enrollment ID: O20031105000809 |
Mailing Address | Practice Location Address |
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Mr Mark A Latta, OD 4140 Marla Dr Ne, Albuquerque, NM 87109-1983 Ph: () - | Mr Mark A Latta, OD Corner Of Route N12 And N7, Fort Defiance, AZ 86504 Ph: (928) 729-8925 |
Dr. Melissa Marie Lester, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: Corner Of Route N12 And N7, Fort Defiance, AZ 86504 Phone: 928-729-8929 | |
Dr. Lakitta Monchelle Woods-dwelle, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: Corner Of Route N12 And N7, Fort Defiance, AZ 86504 Phone: 928-729-8000 | |
Dr. Luisa Rahell Alvarez, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: Corner Of Route N12 And N7, Fort Defiance Hospital Board, Inc., Fort Defiance, AZ 86504 Phone: 951-312-9596 | |
Ryan Nguyen, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: Indian Rte 7 & Indian Route 12, Fort Defiance, AZ 86504 Phone: 928-729-8000 | |
Colby Barton, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: P.o. Box 649 Route N12 And N7, Tsehootsooi Medical Center, Fort Defiance, AZ 86504 Phone: 928-729-8925 | |
Dr. Melissa Marie Walters, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: Corner Of Route N12 And N7, Fort Defiance, AZ 86504 Phone: 928-729-8000 |