Organization
MEDICAL ARTS EYECARE, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODY M SHANKS (OFFICE MANAGER)
(515) 573-1145
Entity
Organization
Contact information
Practice address
1428 2ND AVE N, FORT DODGE, IA 50501-4119
(515) 573-1145
(515) 573-1028
Mailing address
1428 2ND AVE N, FORT DODGE, IA 50501-4119
(515) 573-1145
(515) 573-1028
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
01536
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000389
—
IA
01
—
07134
RY JACOBSON, O.D BCBS
IA
05
—
3066183
—
IA
01
—
38024
PA LENANE, O.D. BCBS
IA
05
—
5145540
—
IA
01
—
IB1233
MEDICARE ID - TYPE UNSPECIFIED
IA
01
—
IB1233001
MEDICARE ID - TYPE UNSPECIFIED
IA
01
—
IB1233002
MEDICARE ID - TYPE UNSPECIFIED
IA
01
—
IB1233003
MEDICARE ID
IA
Enumeration date
12/04/2006
Last updated
07/28/2015
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