| Louis E Boggs, OD | |
|
888 W Houghton Lake Dr, Prudenville, MI 48651-9451 | |
| (989) 366-7525 | |
| (989) 366-5405 |
| Full Name | Louis E Boggs |
|---|---|
| Gender | Male |
| Speciality | Optometrist |
| Location | 888 W Houghton Lake Dr, Prudenville, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134123987 | NPI | - | NPPES |
| 1562533 | Medicaid | MI | |
| 099G21001 | Other | MI | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | MI2953 (Michigan) | Primary |
| Provider Name | Lakeside Vision Prudenville Pc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1003557133 PECOS PAC ID: 8729475769 Enrollment ID: O20220421002588 |
| Mailing Address | Practice Location Address |
|---|---|
| Louis E Boggs, OD 888 W Houghton Lake Dr, Prudenville, MI 48651-9451 Ph: (989) 366-7525 | Louis E Boggs, OD 888 W Houghton Lake Dr, Prudenville, MI 48651-9451 Ph: (989) 366-7525 |
Lakeside Vision, Prudenville, Pc Optometrist Medicare: Medicare Enrolled Practice Location: 888 W Houghton Lake Dr, Prudenville, MI 48651 Phone: 989-366-7525 Fax: 989-366-5405 | |
Lakeside Vision Inc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 888 W Houghton Lake Dr, Prudenville, MI 48651 Phone: 989-366-7525 Fax: 989-366-5405 | |
Dr. Kyle Scott Bates, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 888 W Houghton Lake Dr, Prudenville, MI 48651 Phone: 989-366-7525 |