Southwest Vision Center Inc. | |
69001 M 62, Suite E, Edwardsburg, MI 49112-9131 | |
(989) 289-2669 | |
Not Available |
Full Name | Southwest Vision Center Inc. |
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Type | Facility |
Speciality | Optometrist |
Location | 69001 M 62, Edwardsburg, Michigan |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1871852939 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 4901004625 (Michigan) | Primary |
Provider Name | Jennifer L Lambart |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1538323407 PECOS PAC ID: 7012083793 Enrollment ID: I20111026000575 |
Provider Name | Andrew M Bolles |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1720362585 PECOS PAC ID: 7719150101 Enrollment ID: I20140212001084 |
Provider Name | Katherine M Marshall |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1255740239 PECOS PAC ID: 7012139223 Enrollment ID: I20141103002221 |
Provider Name | Krysten L Avery |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1770670697 PECOS PAC ID: 8628290392 Enrollment ID: I20141112002483 |
Provider Name | Tina Gay Hayes |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1669575361 PECOS PAC ID: 2264863026 Enrollment ID: I20200511002040 |
Provider Name | Dana Hawkins |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1700303807 PECOS PAC ID: 1052716933 Enrollment ID: I20210817000458 |
Mailing Address | Practice Location Address |
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Southwest Vision Center Inc. 69001 M 62, Suite E, Edwardsburg, MI 49112-9131 Ph: () - | Southwest Vision Center Inc. 69001 M 62, Suite E, Edwardsburg, MI 49112-9131 Ph: (989) 289-2669 |
Jennifer Lynn Lambart, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 69001 M 62 Ste E, Edwardsburg, MI 49112 Phone: 269-414-4492 Fax: 269-414-4493 |