| |
886 E Lennon Dr Ste 102, Emory, TX 75440-3216 | |
(903) 474-9090 | |
(903) 474-9111 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 886 E Lennon Dr Ste 102, Emory, Texas |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1619264090 | NPI | - | NPPES |
Provider Name | Eric Lee Ketchum |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1275820649 PECOS PAC ID: 4486824505 Enrollment ID: I20110829000545 |
Mailing Address | Practice Location Address |
---|---|
886 E Lennon Dr Ste 102, Emory, TX 75440-3216 Ph: (903) 474-9090 | 886 E Lennon Dr Ste 102, Emory, TX 75440-3216 Ph: (903) 474-9090 |
Eric Lee Ketchum, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 886 E Lennon Dr Ste 102, Emory, TX 75440 Phone: 903-474-9090 Fax: 903-474-9111 |