| Stanford Vision Clinic LLC | |
|
306 N Commerce St Ripley MS 38663-1721 | |
| (662) 837-7822 | |
| Not Available |
| Full Name | Stanford Vision Clinic LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 306 N Commerce St, Ripley, Mississippi |
| Authorized Official Name and Position | Megan Roebuck Stanford (OPTOMETRIST/OWNER) |
| Authorized Official Contact | 9016470988 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stanford Vision Clinic LLC 306 N Commerce St Ripley MS 38663-1721 Ph: (662) 837-7822 | Stanford Vision Clinic LLC 306 N Commerce St Ripley MS 38663-1721 Ph: (662) 837-7822 |
| NPI Number | 1679044044 |
|---|---|
| Provider Enumeration Date | 12/11/2018 |
| Last Update Date | 12/11/2018 |
| Medicare PECOS PAC ID | 0143563783 |
|---|---|
| Medicare Enrollment ID | O20190522000808 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679044044 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| Provider Name | Megan Roebuck Stanford |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1972951663 PECOS PAC ID: 5597047886 Enrollment ID: I20190522001384 |
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