Provider Demographics
NPI:1215064357
Name:ASHWORTH VISION CLINIC PC
Entity type:Organization
Organization Name:ASHWORTH VISION CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHEETZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:515-440-4610
Mailing Address - Street 1:5970 ASHWORTH RD
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-7110
Mailing Address - Country:US
Mailing Address - Phone:515-440-4610
Mailing Address - Fax:515-440-4611
Practice Address - Street 1:5970 ASHWORTH RD
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-7110
Practice Address - Country:US
Practice Address - Phone:515-440-4610
Practice Address - Fax:515-440-4611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1907152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IADF8829OtherRAILROAD MEDICARE
IAI19989Medicare PIN
IA6055580001Medicare NSC