Jordan Earl, OD | |
1515 E Columbia St, Othello, WA 99344-1846 | |
(509) 488-5256 | |
(509) 488-9939 |
Full Name | Jordan Earl |
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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 |
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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 |