| William T Black | |
|
420 E Elm St, Caldwell, ID 83605-4846 | |
| (208) 459-2020 | |
| (208) 459-2034 |
| Full Name | William T Black |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 420 E Elm St, Caldwell, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588840557 | NPI | - | NPPES |
| 002752500 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | ID0857 (Idaho) | Primary |
| Provider Name | James Bewley |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1639257017 PECOS PAC ID: 9436229200 Enrollment ID: I20080605000276 |
| Provider Name | William T Black |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1063591162 PECOS PAC ID: 0143390047 Enrollment ID: I20080804000317 |
| Provider Name | Stephen Farris |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1619072287 PECOS PAC ID: 5193733251 Enrollment ID: I20151026000607 |
| Provider Name | Candice Anne Galvan |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1063675247 PECOS PAC ID: 6901934074 Enrollment ID: I20151216001562 |
| Provider Name | Douglas Wayne Adams |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1144750886 PECOS PAC ID: 6002185790 Enrollment ID: I20170712002043 |
| Provider Name | Joel Agado Hernandez |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1952831695 PECOS PAC ID: 1355610056 Enrollment ID: I20170712002627 |
| Provider Name | Kendon Delbert Seamons |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1164915534 PECOS PAC ID: 7214280924 Enrollment ID: I20181026000648 |
| Provider Name | Cadence Brunzlick |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1114501681 PECOS PAC ID: 9638579238 Enrollment ID: I20210619000041 |
| Provider Name | Lindsey Anne Belthoff |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1043944630 PECOS PAC ID: 2769866995 Enrollment ID: I20220907001120 |
| Provider Name | Tobin Hale |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467973529 PECOS PAC ID: 5597030767 Enrollment ID: I20230130001057 |
| Provider Name | Nicholas W Gonzales |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1538858279 PECOS PAC ID: 9931569530 Enrollment ID: I20230714000048 |
| Mailing Address | Practice Location Address |
|---|---|
| William T Black 420 E Elm St, Caldwell, ID 83605-4846 Ph: (208) 459-2020 | William T Black 420 E Elm St, Caldwell, ID 83605-4846 Ph: (208) 459-2020 |
Lindsey Anne Belthoff, OD Optometrist Medicare: Medicare Enrolled Practice Location: 420 E Elm St, Caldwell, ID 83605 Phone: 208-459-3366 | |
Mr. William Thomas Black, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 420 E Elm St, Caldwell, ID 83605 Phone: 208-459-2020 Fax: 208-459-2034 | |
Cadence Brunzlick, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1906 Fairview Ave, Caldwell, ID 83605 Phone: 208-459-2020 | |
Amy Marie Neideffer, Optometrist Medicare: Medicare Enrolled Practice Location: 1702 S Kimball Ave, Caldwell, ID 83605 Phone: 208-459-2641 Fax: 208-459-2895 | |
Dr. Christopher Mark Card, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1702 S Kimball Ave, Caldwell, ID 83605 Phone: 208-459-2641 Fax: 208-459-2895 | |
Dr. Kevin Charles Cotter, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 5108 E Cleveland Blvd, Caldwell, ID 83605 Phone: 208-455-2197 | |
Douglas Wayne Adams, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1906 Fairview Ave, Caldwell, ID 83605 Phone: 208-459-2020 Fax: 208-459-2034 |