| Laurie Family Eyecare, Inc. | |
|
138 S. Main, Suite C, Laurie, MO 65037 | |
| (573) 374-5222 | |
| Not Available |
| Full Name | Laurie Family Eyecare, Inc. |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 138 S. Main, Laurie, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871778977 | NPI | - | NPPES |
| DN1000 | Other | MO | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | TO3452 (Missouri) | Primary |
| Provider Name | Lisa K Groves |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1437182284 PECOS PAC ID: 6305896549 Enrollment ID: I20050126000372 |
| Provider Name | Thomas A Dettmer |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1477548527 PECOS PAC ID: 8022038371 Enrollment ID: I20051201000075 |
| Provider Name | Brian R Eveland |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1265449920 PECOS PAC ID: 3072410265 Enrollment ID: I20080423000060 |
| Provider Name | Rachel E Engelbarts |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1396158259 PECOS PAC ID: 6800013178 Enrollment ID: I20180228000166 |
| Provider Name | Brad A Engelbarts |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1740693431 PECOS PAC ID: 6103171145 Enrollment ID: I20180615001675 |
| Mailing Address | Practice Location Address |
|---|---|
| Laurie Family Eyecare, Inc. Po Box 1185, Laurie, MO 65038 Ph: (573) 374-5222 | Laurie Family Eyecare, Inc. 138 S. Main, Suite C, Laurie, MO 65037 Ph: (573) 374-5222 |
John A Gazaway, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 138 S. Main, Suite C, Laurie, MO 65038 Phone: 573-374-5222 Fax: 573-374-7351 | |
Devin Coleman, Optometrist Medicare: Not Enrolled in Medicare Practice Location: 130 S Main St, Laurie, MO 65038 Phone: 573-374-5222 |