MEDICARE: DR. SARAH BETH HIRSCH O.D.

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	152W00000X	Optometrist	2005019550	MO

General Provider Information

NPI Number	:	1003977232
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH BETH HIRSCH O.D.

Provider Business Mailing Address
First Line	:	15933 CLAYTON RD STE 201
Second Line	:
City	:	BALLWIN
State	:	MO
Zip	:	63011-2172
Country	:	US
Telephone Number	:	636-200-4393
Fax Number	:	636-527-0766

Provider Business Practice Location Address
First Line	:	8658 BIG BEND BLVD
Second Line	:
City	:	WEBSTER GROVES
State	:	MO
Zip	:	63119-3839
Country	:	US
Telephone Number	:	314-962-3830
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2006
Last Update Date	:	10/14/2016

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