Healthcare Provider Details

I. General information

NPI: 1174101281
Provider Name (Legal Business Name): CAITLIN TOSO O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2021
Last Update Date: 12/16/2021
Certification Date: 12/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

827 COMMERCIAL ST
EMPORIA KS
66801-2914
US

IV. Provider business mailing address

1527 BERKELEY RD
EMPORIA KS
66801-5559
US

V. Phone/Fax

Practice location:
  • Phone: 620-342-6282
  • Fax:
Mailing address:
  • Phone: 620-481-0559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2155
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: