| NPI Number |
1265545412 |
| Credentials |
OD
(Doctor of Optometry)
|
| Entity |
Individual
|
| Enumeration date |
08/15/2006 |
| Last updated |
01/06/2015 - About 11 years ago
|
| Sole proprietor1 |
Yes
|
| Identifiers |
- MO License #: T03398MO
- MN Medicaid: 1265545412
- MO Other: 1598945859 ADMIRAL LIFE INSURANCE COMPANY OF AMERICA
- MO Other: 0007812292 AETNA
- MO Other: 1598945859 AMERICAN FAMILY INSURANCE
- MO Other: 1598945859 AMERICAN REPUBLIC INSURANCE COMPANY
- MO Other: 000000414171 ANTHEM
- MO Other: 431157294 ANTHEM BLUECROSS BLUESHIELD
- MO Other: 002613709 APWU HEALTH PLAN
- MO Other: 431157294 ARCADIAN COMMUNITY CARE
- MO Other: 1598945859 BLUE CROSS BLUE SHIELD FEDERAL EMPLOYEE PROGRAM
- MO Other: 1598945859 BLUE CROSS BLUE SHIELD OF MINNESOTA
- MO Other: 1598945859 BLUE SHIELD OF CALIFORNIA
- MO Other: 002000052183 CARE IMPROVEMENT PLUS
- MO Other: 1598945859 CARPENTERS' HEALTH & WELFARE TRUST FUND OF ST. LOUIS
- MO Other: 1598945859 CHAMPVA
- MO Other: 1598945859 CHRISTIAN FIDELITY LIFE INSURANCE COMPANY
- MO Other: 431157294 0005 CIGNA
- MO Other: 1598945859 COMBINED INSURANCE COMPANY OF AMERICA
- MO Other: 1598945859 CONSTRUCTION INDUSTRY LABORERES WELFARE FUND
- MO Other: 1598945859 CONTINENTAL LIFE INSURANCE
- MO Other: 1598945859 COOPERATIVE BENEFIT ADMINISTRATORS, INC
- MO Other: 431157294 CORESOURCE
- MO Other: 596488 COVENTRY HEALTH AND LIFE INSURANCE COMPANY
- MO Other: 1598945859 EQUITABLE LIFE AND CASUALTY INSURANCE COMPANY
- MO Other: 431157294 EQUITABLE LIFE AND CASUALTY INSURANCE COMPANY
- MO Other: 1598945859 GOVERNMENT EMPLOYEES HEALTH ASSOCIATION INC
- MO Other: 1598945859 HARTFORD LIFE INSURANCE COMPANY
- MO Other: 431157294 HEARTLAND NATIONAL
- MO Other: 431157294 A HUMANA
- MO Other: 2195676 MAIL HANDLERS BENEFIT PLAN
- MO Other: 431157294 MEDICO INSURANCE COMPANY
- MO Other: 1598945859 MERITAIN HEALTH
- MO Other: 1598945859 MUTUAL OF OMAHA COMPANIES
- MO Other: 1598945859 NATIONAL ASSOCIATIO OF LETTER CARRIERS HEALTH BENEFIT
- MO Other: 431157294-X01 OLD SURETY LIFE INSURANCE COMPANY
- MO Other: 1598945859 PALMETTO GBA - RAILROAD MEDICARE
- MO Other: 410046201 PALMETTO GBA - RAILROAD MEDICARE
- MO Other: 1598945859 PHYSICIANS MUTUAL
- MO Other: 431157294 RESERVE NATIONAL
- MO Other: 431157294 TRANSAMERICA LIFE INSURANCE COMPANY
- MO Other: 1265545412 TRICARE WEST
- MO Other: 431157294 UMR
- MO Other: 0431157294 UNITED COMMERCIAL TRAVELERS OF AMERICA
- MO Other: 1598945859 UNITED WORLD LIFE INSURANCE
- MO Other: 431157294 UNITEDHEALTHCARE
- MO Other: 1265545412 WPS TRICARE
|
| Hospital affiliation |
n/a |
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.