| Dr Theodore E Bogart, OD | |
|
West Route 16, Shelbyville, IL 62565-0199 | |
| (217) 774-4422 | |
| (217) 774-4722 |
| Full Name | Dr Theodore E Bogart |
|---|---|
| Gender | Male |
| Speciality | Optometrist |
| Location | West Route 16, Shelbyville, Illinois |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609950401 | NPI | - | NPPES |
| 046007165 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 046007165 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Theodore E Bogart, OD Po Box 199, Shelbyville, IL 62565-0199 Ph: (217) 774-4422 | Dr Theodore E Bogart, OD West Route 16, Shelbyville, IL 62565-0199 Ph: (217) 774-4422 |
Caitlin Gaughan, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 102 N Heinlein Dr, Shelbyville, IL 62565 Phone: 217-774-4422 | |
Mid-state Eye Partners Inc Optometrist Medicare: Medicare Enrolled Practice Location: 102 N Heinlein Dr, Shelbyville, IL 62565 Phone: 217-774-4422 Fax: 217-772-4722 | |
Joseph T Marcin Jr., Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1401 W Main St, Shelbyville, IL 62565 Phone: 217-774-2181 Fax: 217-774-3104 |