Healthcare Provider Details

I. General information

NPI: 1821153487
Provider Name (Legal Business Name): MARION EYE CENTERS, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2511 N WESTWOOD BLVD
POPLAR BLUFF MO
63901-2338
US

IV. Provider business mailing address

1200 W DEYOUNG ST P.O. BOX 1178
MARION IL
62959-4437
US

V. Phone/Fax

Practice location:
  • Phone: 573-686-5866
  • Fax: 573-686-0425
Mailing address:
  • Phone: 618-993-5686
  • Fax: 618-997-5505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number35374
License Number StateMO

VIII. Authorized Official

Name: LORIANNE RAYNOR
Title or Position: BILLING MANAGER
Credential:
Phone: 618-993-5686