| David A Fullenkamp, OD | |
|
1111 N Meridian St, Portland, IN 47371-1024 | |
| (260) 726-4210 | |
| (260) 726-9347 |
| Full Name | David A Fullenkamp |
|---|---|
| Gender | Male |
| Speciality | Optometry |
| Experience | 41 Years |
| Location | 1111 N Meridian St, Portland, Indiana |
| 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 |
|---|---|---|---|
| 1043297625 | NPI | - | NPPES |
| 100147120 | Medicaid | IN | |
| 2090544 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 18002167A (Indiana) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| David A. Fullenkamp O.d P.c | 0547308033 | 2 |
| Provider Name | David A. Fullenkamp O.d P.c |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1346479284 PECOS PAC ID: 0547308033 Enrollment ID: O20091103000348 |
| Mailing Address | Practice Location Address |
|---|---|
| David A Fullenkamp, OD Po Box 1268, Portland, IN 47371-3268 Ph: (260) 726-4210 | David A Fullenkamp, OD 1111 N Meridian St, Portland, IN 47371-1024 Ph: (260) 726-4210 |
Indiana Vision Group, Llc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1111 N Meridian St, Portland, IN 47371 Phone: 260-726-4210 Fax: 260-726-9347 | |
David A. Fullenkamp, O.d., P.c. Optometrist Medicare: Medicare Enrolled Practice Location: 1111 N Meridian St, Portland, IN 47371 Phone: 260-726-5161 | |
Dr. Abby Elizabeth Small, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1111 N Meridian St, Portland, IN 47371 Phone: 260-726-4210 Fax: 260-726-9347 | |
Eye Center Group, Llc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1111 N Meridian St, Portland, IN 47371 Phone: 260-726-4210 Fax: 260-726-9347 |