| Dr Roger L Wilson, OD | |
| 110 Solana Rd, Ponte Vedra Beach, FL 32082-2230 | |
| (904) 280-2021 | |
| Not Available | 
| Full Name | Dr Roger L Wilson | 
|---|---|
| Gender | Male | 
| Speciality | Optometrist | 
| Location | 110 Solana Rd, Ponte Vedra Beach, Florida | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1215032370 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 152W00000X | Optometrist | OP2569 (Florida) | Primary | 
| Provider Name | Roger L Wilson Od Pa | 
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice | 
| Provider Identifiers | NPI Number: 1164699054 PECOS PAC ID: 4486696317 Enrollment ID: O20050601000520 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Roger L Wilson, OD 110 Solana Rd, Ponte Vedra Beach, FL 32082-2230 Ph: (904) 280-2021 | Dr Roger L Wilson, OD 110 Solana Rd, Ponte Vedra Beach, FL 32082-2230 Ph: (904) 280-2021 | 
| Dr. Gilbert Houston, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 150 Professional Dr, Ste 300, Ponte Vedra Beach, FL 32082 Phone: 904-285-8448 Fax: 904-285-3410 | |
| Susan Rost Monahan, OD Optometrist Medicare: Medicare Enrolled Practice Location: 150 Professional Dr Ste 300, Ponte Vedra Beach, FL 32082 Phone: 904-285-8448 Fax: 904-285-3410 | |
| Karen Sue Wolf, OD Optometrist Medicare: Medicare Enrolled Practice Location: 150 Professional Dr, Ste 300, Ponte Vedra Beach, FL 32082 Phone: 904-285-8448 Fax: 904-285-3410 | |
| Roger L. Wilson, O.d., P.a. Optometrist Medicare: Medicare Enrolled Practice Location: 110 Solana Rd, Ponte Vedra Beach, FL 32082 Phone: 904-280-2021 Fax: 904-280-2024 | |
| Dr. Allison Ann Falden, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 880 A1a N Ste 13, Ponte Vedra Beach, FL 32082 Phone: 954-655-6807 | |
| Drs. Wood, Lanier & Bowman, Pa Optometrist Medicare: Not Enrolled in Medicare Practice Location: 120 A1a N Ste 101, Ponte Vedra Beach, FL 32082 Phone: 904-280-9000 Fax: 904-280-4448 |