| Dr Jackson Riley Fitzgerald, OD | |
|
50 E 4th Ave, Afton, WY 83110-5027 | |
| (307) 885-3975 | |
| Not Available |
| Full Name | Dr Jackson Riley Fitzgerald |
|---|---|
| Gender | Male |
| Speciality | Optometrist |
| Location | 50 E 4th Ave, Afton, Wyoming |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598495384 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 548T (Wyoming) | Secondary |
| 152W00000X | Optometrist | OPT-OPT-LIC-4481 (Montana) | Primary |
| Provider Name | Watson Hayes Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1588123590 PECOS PAC ID: 4486089133 Enrollment ID: O20210322002166 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jackson Riley Fitzgerald, OD 4 S Hillside Dr, Elk Ridge, UT 84651-8501 Ph: (801) 669-3687 | Dr Jackson Riley Fitzgerald, OD 50 E 4th Ave, Afton, WY 83110-5027 Ph: (307) 885-3975 |
Dr. James Edward Moser, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 50 East 4th Ave., Afton, WY 83110 Phone: 307-885-3975 | |
Voss Vision, Llc Optometrist Medicare: Medicare Enrolled Practice Location: 50 East 4th Ave., Afton, WY 83110 Phone: 307-885-3975 | |
Jenning Voss, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 50e 4th Ave, Afton, WY 83110 Phone: 307-885-3975 Fax: 307-885-9612 |