| Potter Family Eye Care, Llc | |
|
5953 W Broadway, Mc Cordsville, IN 46055-9355 | |
| (317) 747-9263 | |
| (317) 747-9271 |
| Full Name | Potter Family Eye Care, Llc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 5953 W Broadway, Mc Cordsville, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801198510 | NPI | - | NPPES |
| 6592970001 | Other | IN | MEDICARE DMEPOS PTAN |
| M100047360 | Other | IN | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 18003358A (Indiana) | Primary |
| 332H00000X | Eyewear Supplier | 18003358A (Indiana) | Secondary |
| Provider Name | Austin David Potter |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1508870742 PECOS PAC ID: 2062597941 Enrollment ID: I20080318000045 |
| Provider Name | Elizabeth M Leburg |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1659668978 PECOS PAC ID: 4284803123 Enrollment ID: I20110809000820 |
| Mailing Address | Practice Location Address |
|---|---|
| Potter Family Eye Care, Llc 5953 W Broadway, Mc Cordsville, IN 46055-9355 Ph: (317) 747-9263 | Potter Family Eye Care, Llc 5953 W Broadway, Mc Cordsville, IN 46055-9355 Ph: (317) 747-9263 |
Dr. Austin David Potter, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 5953 W Broadway, Mc Cordsville, IN 46055 Phone: 317-747-9263 Fax: 317-747-9271 |