| Eagle Vision & Eye Clinic Pc | |
|
2080 N Main St, Longmont, CO 80501-1916 | |
| (303) 651-2020 | |
| (303) 776-2460 |
| Full Name | Eagle Vision & Eye Clinic Pc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 2080 N Main St, Longmont, Colorado |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730299116 | NPI | - | NPPES |
| 04008959 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| Provider Name | Gina Gabriel |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1902889637 PECOS PAC ID: 2961401948 Enrollment ID: I20061221000046 |
| Provider Name | Rachel A Potter |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1730387374 PECOS PAC ID: 6103910823 Enrollment ID: I20070925000574 |
| Provider Name | Jaclyn M Wray |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1194089060 PECOS PAC ID: 4385893312 Enrollment ID: I20121005000430 |
| Provider Name | Justin D Deal |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1134400054 PECOS PAC ID: 2668618919 Enrollment ID: I20130411000484 |
| Provider Name | Kristin Park |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1164046629 PECOS PAC ID: 9638580855 Enrollment ID: I20201119001175 |
| Mailing Address | Practice Location Address |
|---|---|
| Eagle Vision & Eye Clinic Pc 2080 N Main St, Longmont, CO 80501-1916 Ph: (303) 651-2020 | Eagle Vision & Eye Clinic Pc 2080 N Main St, Longmont, CO 80501-1916 Ph: (303) 651-2020 |
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