| Jordan Earl, OD | |
|
1515 E Columbia St, Othello, WA 99344-1846 | |
| (509) 488-5256 | |
| (509) 488-9939 |
| Full Name | Jordan Earl |
|---|---|
| Gender | Male |
| Speciality | Optometrist |
| Location | 1515 E Columbia St, Othello, Washington |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396587200 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | OD61571780 (Washington) | Primary |
| Provider Name | Columbia Basin Health Association |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1528316379 PECOS PAC ID: 4486564309 Enrollment ID: O20040209000250 |
| Mailing Address | Practice Location Address |
|---|---|
| Jordan Earl, OD 1515 E Columbia St, Othello, WA 99344-1846 Ph: (509) 488-5256 | Jordan Earl, OD 1515 E Columbia St, Othello, WA 99344-1846 Ph: (509) 488-5256 |
Jason M Bleazard, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1515 E Columbia St, Othello, WA 99344 Phone: 509-488-5256 Fax: 509-488-9939 | |
Dr. Robert D Forbes, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1515 E Columbia St, Othello, WA 99344 Phone: 509-488-5256 Fax: 509-488-9939 | |
Columbia Basin Health Association Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1515 E Columbia St, Othello, WA 99344 Phone: 509-488-5256 Fax: 509-488-9939 |