Organization
MT VERNON EYE CLINIC PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PEG L FLOCKHART (INSURANCE MANAGER)
(319) 895-8888
Entity
Organization
Contact information
Practice address
202 GLENN ST, MOUNT VERNON, IA 52314-1588
(319) 895-8888
(319) 895-8889
Mailing address
202 GLENN ST, MOUNT VERNON, IA 52314-1588
(319) 895-8888
(319) 895-8889
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0224055
—
IA
01
—
22405
BCBS
IA
Enumeration date
11/14/2006
Last updated
10/29/2008
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