Snake River Eye Associates Of Shelley, Pllc | |
357 W Fir St, Shelley, ID 83274-1456 | |
(208) 881-5145 | |
(208) 881-5146 |
Full Name | Snake River Eye Associates Of Shelley, Pllc |
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Type | Facility |
Speciality | Optometrist |
Location | 357 W Fir St, Shelley, Idaho |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1366794299 | NPI | - | NPPES |
1366794299 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
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152W00000X | Optometrist | (Idaho) | Primary |
Provider Name | Dennis S Radford |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1457461261 PECOS PAC ID: 9335229897 Enrollment ID: I20080109000609 |
Mailing Address | Practice Location Address |
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Snake River Eye Associates Of Shelley, Pllc Po Box K, Shelley, ID 83274-0910 Ph: (208) 881-5145 | Snake River Eye Associates Of Shelley, Pllc 357 W Fir St, Shelley, ID 83274-1456 Ph: (208) 881-5145 |
Dr. Kristan C Sparks, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 169 S Emerson Ave, Shelley, ID 83274 Phone: 208-357-5733 Fax: 208-357-2240 | |
Dr. Justin Thomas Heintz, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 524 N State St, Shelley, ID 83274 Phone: 208-357-5733 Fax: 208-357-2240 | |
Shelley Eyecare Optometrist Medicare: Medicare Enrolled Practice Location: 524 N State St, Shelley, ID 83274 Phone: 208-357-5733 Fax: 208-357-2240 |