MEDICARE: SOUTHEAST KANSAS EYE CARE ASSOCIATES, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	003804	OTHER	KS	BCBS PROVIDER NUMBER

General Provider Information

NPI Number	:	1144297581
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHEAST KANSAS EYE CARE ASSOCIATES, P.A.

Provider Business Mailing Address
First Line	:	1411 W 4TH ST
Second Line	:	SUITE D
City	:	COFFEYVILLE
State	:	KS
Zip	:	67337-3300
Country	:	US
Telephone Number	:	620-251-3235
Fax Number	:	620-251-3252

Provider Business Practice Location Address
First Line	:	1411 W 4TH ST
Second Line	:	SUITE D
City	:	COFFEYVILLE
State	:	KS
Zip	:	67337-3300
Country	:	US
Telephone Number	:	620-251-3235
Fax Number	:	620-251-3252

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GARRICK A RETTELE
Credential	:	M.D.
Telephone Number	:	620-251-3235

Provider Enumeration Date	:	03/03/2006
Last Update Date	:	06/12/2008

Similar Medicare Providers

1801892898 — DR. GARRICK A RETTELE MD
Practice Location Address:

1411 W 4TH ST , STE D
COFFEYVILLE, KS
67337-3300

Practice Phone: 620-251-3235
Practice Fax: 620-251-3252

1578560207 — DR. MAXIME JEAN-MARIE COLES M.D.
Practice Location Address:

1411 W 4TH ST , BUILDING C
COFFEYVILLE, KS
67337-3300

Practice Phone: 620-251-3838
Practice Fax: 620-251-0736

1417948969 — M&T DIAGNOSTIC LAB SERVICES
Practice Location Address:

1411 W 4TH ST
COFFEYVILLE, KS
67337-3300

Practice Phone: 620-251-3666
Practice Fax:

1760450449 — MR. JIMMY LEE POWELL
Practice Location Address:

1411 W 4TH ST
COFFEYVILLE, KS
67337-3300

Practice Phone: 620-251-0050
Practice Fax: 620-251-0050

1265499511 — DR. JAMES M CARVER MD
Practice Location Address:

1411 W 4TH ST STE G
COFFEYVILLE, KS
67337-3300

Practice Phone: 620-251-5400
Practice Fax: 620-251-5412

1073566535 — AMERICAN SLEEP DIAGNOSTICS LLC
Practice Location Address:

1411 W 4TH ST , SUITE F
COFFEYVILLE, KS
67337-3300

Practice Phone: 620-251-7300
Practice Fax: 620-251-7301

Directions to “SOUTHEAST KANSAS EYE CARE ASSOCIATES, P.A. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.