| Mccaulley Optometric Pa | |
|
2601 10th St, Great Bend, KS 67530-4253 | |
| (620) 792-2020 | |
| (620) 792-2583 |
| Full Name | Mccaulley Optometric Pa |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 2601 10th St, Great Bend, Kansas |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043255243 | NPI | - | NPPES |
| 100213630A | Medicaid | KS | |
| 005344 | Other | KS | BCBS GROUP NUMBER |
| 020075001 | Other | KS | CIGNA MC GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 1692 (Kansas) | Secondary |
| 152W00000X | Optometrist | 1198-3 (Kansas) | Primary |
| Provider Name | Chad Thomas Premer |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104897677 PECOS PAC ID: 5294703138 Enrollment ID: I20040920000411 |
| Provider Name | Russell L Mccaulley |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1861463341 PECOS PAC ID: 7618924754 Enrollment ID: I20050331001220 |
| Provider Name | Nicole R Miller |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1700225299 PECOS PAC ID: 8022259530 Enrollment ID: I20130725000805 |
| Provider Name | Sarah L Stueder |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1073033064 PECOS PAC ID: 3678847928 Enrollment ID: I20170925003469 |
| Mailing Address | Practice Location Address |
|---|---|
| Mccaulley Optometric Pa 2601 10th St, Great Bend, KS 67530-4253 Ph: (620) 792-2020 | Mccaulley Optometric Pa 2601 10th St, Great Bend, KS 67530-4253 Ph: (620) 792-2020 |
Dr. Reed Allan Mcatee, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 713 Mckinley St, Great Bend, KS 67530 Phone: 620-792-3535 | |
Sarah Lynn Stueder, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2601 10th St, Great Bend, KS 67530 Phone: 620-792-2020 Fax: 620-792-2583 | |
Dr. Chad T Premer, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2601 10th St, Great Bend, KS 67530 Phone: 620-792-2020 Fax: 620-792-2583 | |
Dr. Kelsey Danielle Elliott, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 713 Mckinley St, Great Bend, KS 67530 Phone: 620-792-3535 Fax: 800-466-7923 | |
Dr. Douglas D. Ayre, Optometrist, Pa Optometrist Medicare: Medicare Enrolled Practice Location: 713 Mckinley, Great Bend, KS 67530 Phone: 620-792-3535 Fax: 620-792-3534 | |
Mark A. Judd, Od Pa Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1701 State Road 96, Great Bend, KS 67530 Phone: 620-792-8733 Fax: 620-792-3621 |