| Snake River Eye Associates Of Shelley, Pllc | |
|
357 W Fir St, Shelley, ID 83274-1456 | |
| (208) 881-5145 | |
| (208) 881-5146 |
| Full Name | Snake River Eye Associates Of Shelley, Pllc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 357 W Fir St, Shelley, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366794299 | NPI | - | NPPES |
| 1366794299 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (Idaho) | Primary |
| Provider Name | Dennis S Radford |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1457461261 PECOS PAC ID: 9335229897 Enrollment ID: I20080109000609 |
| Mailing Address | Practice Location Address |
|---|---|
| Snake River Eye Associates Of Shelley, Pllc Po Box K, Shelley, ID 83274-0910 Ph: (208) 881-5145 | Snake River Eye Associates Of Shelley, Pllc 357 W Fir St, Shelley, ID 83274-1456 Ph: (208) 881-5145 |
Dr. Kristan C Sparks, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 169 S Emerson Ave, Shelley, ID 83274 Phone: 208-357-5733 Fax: 208-357-2240 | |
Dr. Justin Thomas Heintz, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 524 N State St, Shelley, ID 83274 Phone: 208-357-5733 Fax: 208-357-2240 | |
Parkway Eyecare Pc Optometrist Medicare: Medicare Enrolled Practice Location: 524 N State St, Shelley, ID 83274 Phone: 208-357-5733 Fax: 208-357-2240 |