| Kenneth Leon Gortz, OD | |
|
421a E Walton St, Willard, OH 44890-9108 | |
| (419) 933-4327 | |
| (419) 933-4336 |
| Full Name | Kenneth Leon Gortz |
|---|---|
| Gender | Male |
| Speciality | Optometrist |
| Location | 421a E Walton St, Willard, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295973154 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 2891 (Ohio) | Primary |
| Provider Name | Aeg Ohio Professional Pc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1154980811 PECOS PAC ID: 7618207036 Enrollment ID: O20190927002244 |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth Leon Gortz, OD 1500 S County Road 1, Tiffin, OH 44883-9746 Ph: (419) 443-0710 | Kenneth Leon Gortz, OD 421a E Walton St, Willard, OH 44890-9108 Ph: (419) 933-4327 |
Phillip Keysor Optometrist Medicare: Medicare Enrolled Practice Location: 219 Crestwood Dr, Willard, OH 44890 Phone: 419-935-1505 Fax: 419-933-7071 | |
Hookway Eye Care Inc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 320 W Walton St, Willard, OH 44890 Phone: 419-933-2741 Fax: 419-933-7281 | |
Philip Dale Keysor, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 219 Crestwood Dr, Willard, OH 44890 Phone: 419-935-1505 Fax: 419-933-7071 | |
Willard Eye Care Inc Optometrist Medicare: Medicare Enrolled Practice Location: 320 W Walton St, Willard, OH 44890 Phone: 419-933-2741 Fax: 419-933-7281 | |
Dr. Tiffany Procaccini, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 320 W Walton St, Willard, OH 44890 Phone: 419-933-2741 |