Organization
WILLCOCKSON EYE ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEE ALAN GASS (ADMINISTRATOR)
(605) 665-9638
Entity
Organization
Contact information
Practice address
415 W 3RD ST, YANKTON, SD 57078-4201
(605) 665-9638
(605) 665-0526
Mailing address
415 W 3RD ST, YANKTON, SD 57078-4201
(605) 665-9638
(605) 665-0526
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
SD
207W00000X
Ophthalmology Physician
Primary
0017
SD
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000121
SD BLUE SHIELD
SD
Enumeration date
09/20/2006
Last updated
08/02/2011
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