Healthcare Provider Details

I. General information

NPI: 1902254063
Provider Name (Legal Business Name): BRITTANY LYNN SETZER OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRITTANY LYNN PHILLIPS OD

II. Dates (important events)

Enumeration Date: 05/31/2016
Last Update Date: 09/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 W REPUBLIC RD
SPRINGFIELD MO
65807-5730
US

IV. Provider business mailing address

600 N MAIN ST EYE CLINIC
MOUNT VERNON MO
65712-1004
US

V. Phone/Fax

Practice location:
  • Phone: 417-891-4800
  • Fax: 417-891-4922
Mailing address:
  • Phone: 417-466-0182
  • Fax: 417-466-0126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2016039128
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: