Kenneth S Stoller (NPI# 1326080169, PAC ID# 2365579158) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1326080169 |
| PAC ID by PECOS | 2365579158 |
| Professional Enrollment ID | I20100428000055 |
| Full Name | Kenneth S Stoller |
| Organization Legal Name | EYE CARE OPTOMETRY INC. |
| Address |
1755 Dix Hwy Lincoln Park MI 48146-1412 |
| Phone Number | 3133829650 |
| Gender | M |
| Medical School | ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO |
| Graduation Year | 1980 |
| Primary Specialty | OPTOMETRY |
| Group Practice PAC ID | 8224166681 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 1755 Dix Hwy, Lincoln Park, MI 48146-1412 | 3133829650 | EYE CARE OPTOMETRY INC. |
| Organization Legal Name | EYE CARE OPTOMETRY INC. |
| Physicians | 1 |
| Street Address |
1755 DIX HWY |
| City | LINCOLN PARK |
| State | MI |
| Zip | 48146-1412 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Barbara A Hannah | Obstetrics/gynecology | 25050 Outer Dr, Suite 102, Lincoln Park, MI 48146-1293 | |
| Mahmood Khan | Internal Medicine | 25880 W Outer Dr, Lincoln Park, MI 48146-1553 | |
| Durene M Elem Vaughn | Podiatry | 1111 Fort St, Lincoln Park, MI 48146-1802 | |
| Ali Ateya | Physician Assistant | Acadian Clinic Pllc | 1158 Fort St, Lincoln Park, MI 48146-1840 |
| Ahlam Toma | Nurse Practitioner | Acadian Clinic Pllc | 1158 Fort St, Lincoln Park, MI 48146-1840 |
| Eqdam Radhi | Internal Medicine | 1158 Fort St, Lincoln Park, MI 48146-1840 | |
| Matthew Matty | Physician Assistant | Get Well Urgent Care Downriver Plc | 1779 Fort St, Lincoln Park, MI 48146-1901 |
| Peter Matty | Physician Assistant | Get Well Urgent Care Downriver Plc | 1779 Fort St, Lincoln Park, MI 48146-1901 |
| Pamela E Stolz | Clinical Social Worker | Community Care Services | 26184 W Outer Dr, Lincoln Park, MI 48146-2084 |
| Ellen O Robey | Clinical Social Worker | Community Care Services | 26184 W Outer Dr, Lincoln Park, MI 48146-2084 |
| Find all physicians in zip 48146 | |||
| City | LINCOLN PARK |
| Zip Code | 48146 |
| Specialty | OPTOMETRY |
| City + Specialty | LINCOLN PARK + OPTOMETRY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.