| Patrick Willer | |
|
3911 E State Route 69 Prescott AZ 86301-6717 | |
| (928) 442-0707 | |
| Not Available |
| Full Name | Patrick Willer |
|---|---|
| Speciality | Clinic/Center |
| Location | 3911 E State Route 69, Prescott, Arizona |
| Authorized Official Name and Position | Patrick Willer (PRESIDENT) |
| Authorized Official Contact | 9284420707 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Patrick Willer 3911 E State Route 69 Prescott AZ 86301-6717 Ph: (928) 442-0707 | Patrick Willer 3911 E State Route 69 Prescott AZ 86301-6717 Ph: (928) 442-0707 |
| NPI Number | 1881102416 |
|---|---|
| Provider Enumeration Date | 01/17/2018 |
| Last Update Date | 01/17/2018 |
| Medicare PECOS PAC ID | 2163781949 |
|---|---|
| Medicare Enrollment ID | O20180124002623 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881102416 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Patrick A Willer |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1083787030 PECOS PAC ID: 0244258432 Enrollment ID: I20051107000192 |
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