| Roger B Ethington, MD | |
|
371 W Central Ave, Coolidge, AZ 85128-4706 | |
| (520) 723-3000 | |
| (520) 723-5393 |
| Full Name | Roger B Ethington |
|---|---|
| Gender | Male |
| Speciality | Optometrist |
| Location | 371 W Central Ave, Coolidge, Arizona |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679545776 | NPI | - | NPPES |
| 034273 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 552 (Arizona) | Primary |
| Provider Name | Southwestern Eye Center Ltd |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1023063187 PECOS PAC ID: 1850296989 Enrollment ID: O20031203000181 |
| Provider Name | Barnet Dulaney Perkins Eye Center, Pc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1376574707 PECOS PAC ID: 0749288298 Enrollment ID: O20061117000349 |
| Mailing Address | Practice Location Address |
|---|---|
| Roger B Ethington, MD 4800 N 22nd St Ste 210, Phoenix, AZ 85016-4963 Ph: (480) 892-8400 | Roger B Ethington, MD 371 W Central Ave, Coolidge, AZ 85128-4706 Ph: (520) 723-3000 |
Kate L Trinh, Optometrist Medicare: Accepting Medicare Assignments Practice Location: 371 W Central Ave, Coolidge, AZ 85128 Phone: 480-892-8400 Fax: 602-508-4830 | |
Mr. Rasha Kumar, OPTOMETRIST OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1695 North Arizona Boulevard, Coolidge, AZ 85228 Phone: 520-723-8641 Fax: 520-723-8643 |