| Dr Scott Richard Ecenbarger, OD | |
|
5751 Byron Center Ave Sw, Suite V, Wyoming, MI 49519-9621 | |
| (616) 532-2020 | |
| (616) 532-2022 |
| Full Name | Dr Scott Richard Ecenbarger |
|---|---|
| Gender | Male |
| Speciality | Optometry |
| Experience | 26 Years |
| Location | 5751 Byron Center Ave Sw, Wyoming, Michigan |
| 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 |
|---|---|---|---|
| 1629019914 | NPI | - | NPPES |
| 94-4712563 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 4901004003 (Michigan) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Ecenbarger Eye Care, Llc | 4284634122 | 2 |
| Provider Name | Ecenbarger Eye Care, Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1609959089 PECOS PAC ID: 4284634122 Enrollment ID: O20061228000095 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Scott Richard Ecenbarger, OD 5751 Byron Center Ave Sw, Suite V, Wyoming, MI 49519-9621 Ph: (616) 532-2020 | Dr Scott Richard Ecenbarger, OD 5751 Byron Center Ave Sw, Suite V, Wyoming, MI 49519-9621 Ph: (616) 532-2020 |
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