Organization
MARK L. BOTTELSON, O.D. AND ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELAINE RAHE BOTTELSON (INSURANCE MANAGER)
(515) 274-6452
Entity
Organization
Contact information
Practice address
1001 73RD ST, VISION CENTER, WINDSOR HEIGHTS, IA 50324-1311
(515) 274-6452
(515) 274-6306
Mailing address
1001 73RD ST, VISION CENTER, WINDSOR HEIGHTS, IA 50324-1311
(515) 274-6452
(515) 274-6306
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1684
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3167973
—
IA
01
—
36759
BLUE CROSS BLUE SHIELD
IA
01
—
551764
NATIONAL VISION ADMIN.
—
01
—
6151
MIDLANDS CHOICE
IA
01
—
9391471
PRIVATE HEALTH CARE SYSTE
—
Enumeration date
10/15/2005
Last updated
07/13/2009
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