| Jill M Lane Llc | |
|
405 E Main St, Grangeville, ID 83530-2239 | |
| (208) 983-3732 | |
| (208) 983-3738 |
| Full Name | Jill M Lane Llc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 405 E Main St, Grangeville, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902078785 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | ODP-100095 (Idaho) | Primary |
| Provider Name | Jill M Lane |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1427119254 PECOS PAC ID: 9739197807 Enrollment ID: I20060331000014 |
| Mailing Address | Practice Location Address |
|---|---|
| Jill M Lane Llc 405 E Main St, Grangeville, ID 83530-2239 Ph: (208) 983-3732 | Jill M Lane Llc 405 E Main St, Grangeville, ID 83530-2239 Ph: (208) 983-3732 |
Dr. Jill Marie Lane, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 405 E Main St, Grangeville, ID 83530 Phone: 208-983-3732 Fax: 208-983-3738 | |
Dr. Joel I Brown, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 622 W North St, Grangeville, ID 83530 Phone: 208-983-0260 Fax: 208-983-0047 |