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Contact Information

MARK J REDDAN, OD
900 N HIGHWAY 67
FLORISSANT, MO63031-2919
 Phone: 314-838-0300
 Fax: 314-838-4682
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for MARK J REDDAN · (Male)

NPI Number 1558390229
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 07/03/2006
Last updated 11/09/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • MO License # T02531
  • MO Other 257404410 MISSOURI LICENSE
Hospital affiliation(s) Not Available
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.

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