| |
145 Myrtle St, Suite 108, Sutherlin, OR 97479-9113 | |
(541) 459-4333 | |
(541) 459-7512 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 145 Myrtle St, Sutherlin, Oregon |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1407969322 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 2872T (Oregon) | Primary |
Provider Name | Toby J Palm |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1366430936 PECOS PAC ID: 3375443260 Enrollment ID: I20061016000593 |
Mailing Address | Practice Location Address |
---|---|
145 Myrtle St, Suite 108, Sutherlin, OR 97479-9113 Ph: (541) 459-4333 | 145 Myrtle St, Suite 108, Sutherlin, OR 97479-9113 Ph: (541) 459-4333 |
Dr. Toby Palm, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 201 Dakota Street, Sutherlin, OR 97479 Phone: 541-459-4333 Fax: 541-459-7512 |