Roger B Ethington, MD | |
371 W Central Ave, Coolidge, AZ 85128-4706 | |
(520) 723-3000 | |
(520) 723-5393 |
Full Name | Roger B Ethington |
---|---|
Gender | Male |
Speciality | Optometrist |
Location | 371 W Central Ave, Coolidge, Arizona |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1679545776 | NPI | - | NPPES |
034273 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 552 (Arizona) | Primary |
Provider Name | Southwestern Eye Center, Ltd |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1023063187 PECOS PAC ID: 1850296989 Enrollment ID: O20031203000181 |
Provider Name | Barnet Dulaney Perkins Eye Center, Pc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1376574707 PECOS PAC ID: 0749288298 Enrollment ID: O20061117000349 |
Mailing Address | Practice Location Address |
---|---|
Roger B Ethington, MD 4800 N 22nd St Ste 210, Phoenix, AZ 85016-4963 Ph: (480) 892-8400 | Roger B Ethington, MD 371 W Central Ave, Coolidge, AZ 85128-4706 Ph: (520) 723-3000 |
Kate L Trinh, Optometrist Medicare: Accepting Medicare Assignments Practice Location: 371 W Central Ave, Coolidge, AZ 85128 Phone: 480-892-8400 Fax: 602-508-4830 | |
Mr. Rasha Kumar, OPTOMETRIST OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1695 North Arizona Boulevard, Coolidge, AZ 85228 Phone: 520-723-8641 Fax: 520-723-8643 |