| Eye State Optometry, Llc | |
|
3105 Grand Ave Ames IA 50010-4604 | |
| (515) 441-8127 | |
| Not Available |
| Full Name | Eye State Optometry, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3105 Grand Ave, Ames, Iowa |
| Authorized Official Name and Position | Mallori Phillips (OPTOMETRIST/OWNER) |
| Authorized Official Contact | 5152930708 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eye State Optometry, Llc 101 Cyclone Ln Madrid IA 50156-7610 Ph: (515) 293-0708 | Eye State Optometry, Llc 3105 Grand Ave Ames IA 50010-4604 Ph: (515) 441-8127 |
| NPI Number | 1477037000 |
|---|---|
| Provider Enumeration Date | 09/19/2018 |
| Last Update Date | 09/19/2018 |
| Medicare PECOS PAC ID | 7618220112 |
|---|---|
| Medicare Enrollment ID | O20181031000954 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477037000 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Mallori Phillips |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1326539826 PECOS PAC ID: 8527311026 Enrollment ID: I20181031001015 |
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