| Grady D. Gafford Md Pc | |
|
15 Meade St, Suite 1, Wellsboro, PA 16901-1813 | |
| (570) 724-2131 | |
| (570) 724-5471 |
| Full Name | Grady D. Gafford Md Pc |
|---|---|
| Type | Facility |
| Speciality | Ophthalmology |
| Location | 15 Meade St, Wellsboro, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184635286 | NPI | - | NPPES |
| 001045419 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | OEG000806 (Pennsylvania) | Secondary |
| 207W00000X | Ophthalmology | MD025213E (Pennsylvania) | Primary |
| Provider Name | Jodi Duda |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1144237116 PECOS PAC ID: 1153211586 Enrollment ID: I20040318000611 |
| Provider Name | Daniel Joseph Fassero |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1750489894 PECOS PAC ID: 1254372048 Enrollment ID: I20050523000289 |
| Provider Name | Scott P Rutkoski |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1750392775 PECOS PAC ID: 2769403385 Enrollment ID: I20051212000245 |
| Provider Name | Avery Boardman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1073603718 PECOS PAC ID: 5092828905 Enrollment ID: I20110602000181 |
| Provider Name | Grady D Gafford |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1649281627 PECOS PAC ID: 0446271779 Enrollment ID: I20111117000278 |
| Mailing Address | Practice Location Address |
|---|---|
| Grady D. Gafford Md Pc 15 Meade St, Suite 1, Wellsboro, PA 16901-1813 Ph: (570) 724-2131 | Grady D. Gafford Md Pc 15 Meade St, Suite 1, Wellsboro, PA 16901-1813 Ph: (570) 724-2131 |