| Mark T Eggleston, MD | |
|
500 Port Drive, Clarkston, WA 99403-1835 | |
| (509) 758-8811 | |
| (509) 751-1188 |
| Full Name | Mark T Eggleston |
|---|---|
| Gender | Male |
| Speciality | Ophthalmology |
| Experience | 28 Years |
| Location | 500 Port Drive, Clarkston, Washington |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306836705 | NPI | - | NPPES |
| 000010033114 | Other | ID | REGENCE BLUE SHIELD OF IDAHO |
| 0152789 | Other | WA | LABOR & INDUSTRY |
| 806011100 | Medicaid | ID | |
| MXXPR0054708 | Other | WA | MOLINA HEALTHCARE |
| 0000100033114 | Other | FEDERAL BLUE CROSS | |
| 24509 | Other | WA | GROUP HEALTH COOPERATIVE |
| BYHD5 | Other | ID | BLUE CROSS OF IDAHO |
| 000010145029 | Other | ID | REGENCE BLUE SHIELD OF IDAHO |
| 8293425 | Medicaid | WA | |
| 8928983 | Other | WA | CRIME VICTIMES COMPENSATION ACT |
| 42663 | Other | ID | BLUE CROSS OF IDAHO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207W00000X | Ophthalmology | MD00039323 (Washington) | Primary |
| 207W00000X | Ophthalmology | M8239 (Idaho) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Tri-state Memorial Hospital | Clarkston, WA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Eye Care Specialists Ps | 3779473723 | 2 |
| Eye Care Specialists Ps | 3779473723 | 2 |
| Entity Name | Eye Care Specialists Ps |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639160450 PECOS PAC ID: 3779473723 Enrollment ID: O20040317000302 |
| Mailing Address | Practice Location Address |
|---|---|
| Mark T Eggleston, MD 500 Port Drive, Clarkston, WA 99403-1835 Ph: (509) 758-8811 | Mark T Eggleston, MD 500 Port Drive, Clarkston, WA 99403-1835 Ph: (509) 758-8811 |
Chad Ryan Bouterse, D.O. Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 500 Port Dr, Clarkston, WA 99403 Phone: 509-758-8811 Fax: 509-751-1188 | |
Mr. Richard J Eggleston, MD Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 500 Port Dr, Clarkston, WA 99403 Phone: 509-758-8811 Fax: 509-751-1188 |