| Thornapple Ophthalmology Assoc Pc | |
|
915 W Green St, Suite 101, Hastings, MI 49058-1724 | |
| (269) 945-3866 | |
| Not Available |
| Full Name | Thornapple Ophthalmology Assoc Pc |
|---|---|
| Type | Facility |
| Speciality | Ophthalmology |
| Location | 915 W Green St, Hastings, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396832937 | NPI | - | NPPES |
| 102575680 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 4901004379 (Michigan) | Secondary |
| 152W00000X | Optometrist | 4901004439 (Michigan) | Secondary |
| 207W00000X | Ophthalmology | 4301047122 (Michigan) | Primary |
| Provider Name | David D Harrell |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1902860661 PECOS PAC ID: 9931134145 Enrollment ID: I20050927000794 |
| Provider Name | Chad J Jackson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1780772533 PECOS PAC ID: 8921025636 Enrollment ID: I20051102000147 |
| Provider Name | Michael J Flohr |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1669564720 PECOS PAC ID: 3476652470 Enrollment ID: I20070615000175 |
| Provider Name | Brian L Weller |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1841477783 PECOS PAC ID: 8820155575 Enrollment ID: I20090324000461 |
| Provider Name | Sarah Declarke |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1679189989 PECOS PAC ID: 9133534241 Enrollment ID: I20210224000329 |
| Mailing Address | Practice Location Address |
|---|---|
| Thornapple Ophthalmology Assoc Pc 915 W Green St, Suite 101, Hastings, MI 49058-1723 Ph: (269) 945-3866 | Thornapple Ophthalmology Assoc Pc 915 W Green St, Suite 101, Hastings, MI 49058-1724 Ph: (269) 945-3866 |