| |
1469 Capitol St Ne, 100, Salem, OR 97301-7875 | |
(503) 391-9570 | |
(503) 763-7230 |
Full Name | |
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Type | Facility |
Speciality | Eyewear Supplier |
Location | 1469 Capitol St Ne, Salem, Oregon |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1144412701 | NPI | - | NPPES |
1558448753 | Other | OR | INDIVIDUAL NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 3012ATI (Oregon) | Secondary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Provider Name | Darek A Huggett |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1558448753 PECOS PAC ID: 4789676073 Enrollment ID: I20040330000523 |
Mailing Address | Practice Location Address |
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1469 Capitol St Ne, 100, Salem, OR 97301-7875 Ph: (503) 391-9570 | 1469 Capitol St Ne, 100, Salem, OR 97301-7875 Ph: (503) 391-9570 |