| Nicole Lee Gates, | |
|
30652 Red Rock Ct, Logan, OH 43138-9670 | |
| (740) 385-4006 | |
| Not Available |
| Full Name | Nicole Lee Gates |
|---|---|
| Gender | Female |
| Speciality | Optometrist |
| Location | 30652 Red Rock Ct, Logan, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073251708 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | OPT.007033 (Ohio) | Primary |
| Provider Name | Buckeye Vision Care |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1790889491 PECOS PAC ID: 5799780763 Enrollment ID: O20060926000100 |
| Mailing Address | Practice Location Address |
|---|---|
| Nicole Lee Gates, 673 W Washington St, Nelsonville, OH 45764-9745 Ph: (740) 517-0977 | Nicole Lee Gates, 30652 Red Rock Ct, Logan, OH 43138-9670 Ph: (740) 385-4006 |
Jenna Katherine Tyler, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 57 S Walnut St, Logan, OH 43138 Phone: 740-385-4006 | |
Milton C Mason, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 498 W Hunter St, Logan, OH 43138 Phone: 740-385-4017 Fax: 740-385-7666 | |
Dr. Lawrence Jonathan Mesarch, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 57 S Walnut St, Logan, OH 43138 Phone: 740-385-4006 Fax: 740-385-4043 | |
S Louis Berta, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 15171 Burcham Rd, Logan, OH 43138 Phone: 740-385-6545 | |
Kelly Rowe, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 30652 Red Rock Ct, Logan, OH 43138 Phone: 740-385-4006 | |
Thomas S Price, Optometrist Medicare: Not Enrolled in Medicare Practice Location: 158 E Main St, Logan, OH 43138 Phone: 740-385-4006 Fax: 740-385-4043 |