# WILLCOCKSON EYE ASSOCIATES, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992802920
- **Authorized official:** MR. LEE ALAN GASS (ADMINISTRATOR)
- **Authorized official phone:** (605) 665-9638

## Contact information

- **Practice address:** 415 W 3RD ST, YANKTON, SD 57078-4201
- **Practice address phone:** (605) 665-9638
- **Practice address fax:** (605) 665-0526
- **Mailing address:** 415 W 3RD ST, YANKTON, SD 57078-4201
- **Mailing address phone:** (605) 665-9638
- **Mailing address fax:** (605) 665-0526

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | SD | — |
| 207W00000X | Ophthalmology Physician | 0017 | SD | Yes |
| 332H00000X | Eyewear Supplier | — | NULL | — |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 08/02/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0000121 | SD BLUE SHIELD | SD |