Organization
WINCKLER VISION CENTER, INC.
Active
Other names
Pine Ridge Vision Center
Organization subpart
No
Provider details
NPI number
Authorized official
MARK R WINCKLER (INSURANCE & CREDENTIALING)
(605) 867-2772
Entity
Organization
Contact information
Practice address
207 E MAIN ST STE 1, PINE RIDGE, SD 57770-3184
(605) 867-2772
(605) 867-2772
Mailing address
PO BOX 399, HWY 18, PINE RIDGE, SD 57770-0399
(605) 867-2772
(605) 867-2320
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4993075
WELLMARK BCBS
SD
01
—
4993076
WELLMARK BCBS
SD
01
—
4993077
WELLMARK BCBS
SD
01
—
4993078
WELLMARK BCBS
SD
05
—
9200333
—
SD
05
—
9202143
—
SD
05
—
9203683
—
SD
05
—
9280200
—
SD
Enumeration date
07/26/2006
Last updated
01/12/2024
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