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NPI Code Detail

MEDICARE: NATHAN HURST OD

MEDICARE:   NATHAN  HURST  OD
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
1152W00000XOptometrist2026021551MO

General Provider Information

NPI Number : 1114857406
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHAN HURST OD
Provider Business Mailing Address
First Line : 2751 N WESTWOOD BLVD
Second Line :
City : POPLAR BLUFF
State : MO
Zip : 63901-2346
Country : US
Telephone Number : 573-785-5500
Fax Number :
Provider Business Practice Location Address
First Line : 2751 N WESTWOOD BLVD
Second Line :
City : POPLAR BLUFF
State : MO
Zip : 63901-2346
Country : US
Telephone Number : 573-785-5500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2026
Last Update Date : 05/20/2026

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Directions to “ NATHAN HURST OD” Practice Location

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