Healthcare Provider Details

I. General information

NPI: 1033115019
Provider Name (Legal Business Name): AMBER KARPEL O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2005
Last Update Date: 12/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2185 S MASON RD
SAINT LOUIS MO
63131-1640
US

IV. Provider business mailing address

15933 CLAYTON RD STE 201
BALLWIN MO
63011-2172
US

V. Phone/Fax

Practice location:
  • Phone: 314-821-5666
  • Fax: 314-821-5322
Mailing address:
  • Phone: 636-200-4393
  • Fax: 636-527-0766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2000160786
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: