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3500 Dodge St Ste 110b, Dubuque, IA 52003-5208 | |
(563) 583-5895 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Eyewear Supplier |
Location | 3500 Dodge St Ste 110b, Dubuque, Iowa |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1588220974 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Provider Name | Gerrie L Lubben |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1043202922 PECOS PAC ID: 8921016981 Enrollment ID: I20060713000344 |
Provider Name | Ben Cannon |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1770868820 PECOS PAC ID: 6305061136 Enrollment ID: I20140710000933 |
Provider Name | Brittany J Krause |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1801148143 PECOS PAC ID: 4284949645 Enrollment ID: I20150813010604 |
Provider Name | Theresa M Mccartney |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1609256627 PECOS PAC ID: 0244549228 Enrollment ID: I20151013001445 |
Provider Name | Morgan Elizabeth Wichman |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1003460734 PECOS PAC ID: 6608260658 Enrollment ID: I20220308002155 |
Provider Name | Tracey Payne |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1922140748 PECOS PAC ID: 7214335900 Enrollment ID: I20230424001431 |
Provider Name | Samantha Jane Thompson |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1053164525 PECOS PAC ID: 5092257881 Enrollment ID: I20240607002422 |
Mailing Address | Practice Location Address |
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Po Box 19060, Green Bay, WI 54307-9060 Ph: () - | 3500 Dodge St Ste 110b, Dubuque, IA 52003-5208 Ph: (563) 583-5895 |