| Carlson Tillisch Eye Clinic, Ltd | |
|
120 N Broad St, Mankato, MN 56001-3518 | |
| (507) 345-5087 | |
| (507) 345-1151 |
| Full Name | Carlson Tillisch Eye Clinic, Ltd |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 120 N Broad St, Mankato, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225116932 | NPI | - | NPPES |
| 960103100 | Other | MN | MEDICAL ASSISTANCE |
| 41663TI | Other | MN | BLUE CROSS & BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| Provider Name | Matthew Downs |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1205857042 PECOS PAC ID: 5496652968 Enrollment ID: I20031215000363 |
| Provider Name | Tracye D Rasmussen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1982702247 PECOS PAC ID: 3375550072 Enrollment ID: I20060321000125 |
| Provider Name | George John Lach |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1609826577 PECOS PAC ID: 6002713567 Enrollment ID: I20110124001268 |
| Provider Name | Murphy M Grotewold |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1376049031 PECOS PAC ID: 2264781806 Enrollment ID: I20180815002522 |
| Provider Name | Dustin Lee Deutsch |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1255900874 PECOS PAC ID: 6204239700 Enrollment ID: I20210721002390 |
| Mailing Address | Practice Location Address |
|---|---|
| Carlson Tillisch Eye Clinic, Ltd 120 N Broad St, Mankato, MN 56001-3518 Ph: (507) 345-5087 | Carlson Tillisch Eye Clinic, Ltd 120 N Broad St, Mankato, MN 56001-3518 Ph: (507) 345-5087 |
Jacqueline Alice Rooney, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1701 Madison Ave, Mankato, MN 56001 Phone: 507-387-6517 | |
Dr. Matthew R Downs, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 120 N Broad St, Mankato, MN 56001 Phone: 507-345-5087 Fax: 507-345-1151 | |
Michael Jackson, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1850 Adams St Ste 112, Mankato, MN 56001 Phone: 507-387-6358 Fax: 507-387-4166 | |
Dr. Dale L Carlson, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 220 East Main, Mankato, MN 56002 Phone: 507-345-5087 Fax: 507-345-1151 | |
Murphy Grotewold, Optometrist Medicare: Accepting Medicare Assignments Practice Location: 220 E Main St, Mankato, MN 56001 Phone: 507-345-5087 | |
Dr. Nathaniel Lee Graham, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1421 Premier Dr, Mankato, MN 56001 Phone: 507-385-4070 |