| Vision Source Tifton | |
|
2012 Pineview Ave, Tifton, GA 31794-3035 | |
| (229) 382-4765 | |
| (229) 382-4819 |
| Full Name | Vision Source Tifton |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 2012 Pineview Ave, Tifton, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578630794 | NPI | - | NPPES |
| 410029773 | Other | GA | MEDICARE RAILROAD |
| 300031267A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | GA1397 (Georgia) | Primary |
| Provider Name | Ted A Mcelroy |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1518959352 PECOS PAC ID: 2567598816 Enrollment ID: I20111222000013 |
| Provider Name | Julia Danielle Harrison |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1073004602 PECOS PAC ID: 0840540886 Enrollment ID: I20180912001861 |
| Mailing Address | Practice Location Address |
|---|---|
| Vision Source Tifton Po Box 1186, Tifton, GA 31793-1186 Ph: (229) 382-4765 | Vision Source Tifton 2012 Pineview Ave, Tifton, GA 31794-3035 Ph: (229) 382-4765 |
South Georgia Eye Partners Optometrist Medicare: Not Enrolled in Medicare Practice Location: 416 Tift Ave N, Tifton, GA 31794 Phone: 229-391-4180 Fax: 229-391-2929 | |
Kenneth Trevor Shealy, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1803 Old Ocilla Rd, Tifton, GA 31794 Phone: 229-386-2181 Fax: 229-386-2193 | |
Janine Tran Nguyen, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 2012 Pineview Ave, Tifton, GA 31794 Phone: 229-382-4765 Fax: 229-382-4819 | |
South Georgia Eye Partners Pc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 416 Tift Ave N, Tifton, GA 31794 Phone: 229-391-4180 Fax: 229-391-2929 | |
Michael J Garner Od Pc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1830 Hwy 82 W, Tifton, GA 31793 Phone: 229-387-8863 | |
Dr. Ted A Mcelroy, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2012 Pineview Ave, Tifton, GA 31794 Phone: 229-382-4765 Fax: 229-382-4819 |