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Contact Information

AMY J KNICKERBOCKER, OD
3650 STARDUST DRIVE
HANNIBAL, MO63401
 Phone: 573-406-1503
 Fax: 573-406-1057
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for AMY J KNICKERBOCKER · (Female)

NPI # 1578517306
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 05/19/2006
Last updated 03/25/2014 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 046009247
  • MO License # 200143624
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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