William Martin Grovenburg, OD | |
1103 W Center St, Collinsville, OK 74021-3108 | |
(918) 371-3339 | |
Not Available |
Full Name | William Martin Grovenburg |
---|---|
Gender | Male |
Speciality | Optometrist |
Location | 1103 W Center St, Collinsville, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1336820547 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 3225 (Oklahoma) | Primary |
Provider Name | Collinsville Primary Eyecare |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1699304469 PECOS PAC ID: 2365860723 Enrollment ID: O20200916002195 |
Mailing Address | Practice Location Address |
---|---|
William Martin Grovenburg, OD 11730 E 119th St N, Collinsville, OK 74021-1022 Ph: (719) 200-3931 | William Martin Grovenburg, OD 1103 W Center St, Collinsville, OK 74021-3108 Ph: (918) 371-3339 |
Dr. Leonard Duane Hart, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1103 W Center St, Collinsville, OK 74021 Phone: 918-371-3339 Fax: 918-371-9600 | |
Collinsville Primary Eyecare Optometrist Medicare: Medicare Enrolled Practice Location: 1103 W Center St, Collinsville, OK 74021 Phone: 918-371-3339 | |
Primary Eye Care Associates Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1103 W Center St, Collinsville, OK 74021 Phone: 918-371-3339 Fax: 918-371-9600 |