| |
32 Main St W, Mayville, ND 58257-1314 | |
(701) 786-2666 | |
(701) 786-2292 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 32 Main St W, Mayville, North Dakota |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1609062272 | NPI | - | NPPES |
60602 | Medicaid | ND |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 575 (North Dakota) | Primary |
Provider Name | Michael K Rexine |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1700899143 PECOS PAC ID: 3971560327 Enrollment ID: I20041220000307 |
Provider Name | Vanessa R Manlove |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1376194472 PECOS PAC ID: 1951735125 Enrollment ID: I20191220001079 |
Mailing Address | Practice Location Address |
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32 Main St W, Mayville, ND 58257-1314 Ph: (701) 786-2666 | 32 Main St W, Mayville, ND 58257-1314 Ph: (701) 786-2666 |
Dr. Michael Kenneth Rexine, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 32 Main St W, Mayville, ND 58257 Phone: 701-786-2666 Fax: 701-786-2292 |