| Winckler Vision Center, Inc. | |
|
207 E Main St Ste 1, Pine Ridge, SD 57770-3184 | |
| (605) 867-2772 | |
| (605) 867-2772 |
| Full Name | Winckler Vision Center, Inc. |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 207 E Main St Ste 1, Pine Ridge, South Dakota |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134142243 | NPI | - | NPPES |
| 4993076 | Other | SD | WELLMARK BCBS |
| 4993078 | Other | SD | WELLMARK BCBS |
| 9200333 | Medicaid | SD | |
| 9202143 | Medicaid | SD | |
| 9280200 | Medicaid | SD | |
| 4993075 | Other | SD | WELLMARK BCBS |
| 4993077 | Other | SD | WELLMARK BCBS |
| 9203683 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| Provider Name | Mark R Winckler |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1538268388 PECOS PAC ID: 6406854173 Enrollment ID: I20070705000162 |
| Provider Name | Timothy L Chancellor |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1417916321 PECOS PAC ID: 2365546637 Enrollment ID: I20070705000185 |
| Provider Name | Bradley Marcy |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1336581503 PECOS PAC ID: 8123262714 Enrollment ID: I20140902001649 |
| Mailing Address | Practice Location Address |
|---|---|
| Winckler Vision Center, Inc. Po Box 399, Hwy 18, Pine Ridge, SD 57770-0399 Ph: (605) 867-2772 | Winckler Vision Center, Inc. 207 E Main St Ste 1, Pine Ridge, SD 57770-3184 Ph: (605) 867-2772 |
Mark R Winckler, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 207 E Main St Ste 1, Pine Ridge, SD 57770 Phone: 605-867-2772 |