Healthcare Provider Details

I. General information

NPI: 1447225867
Provider Name (Legal Business Name): KURT WALTER FINKLANG O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2006
Last Update Date: 12/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 PROFESSIONAL PKWY
TROY MO
63379-2822
US

IV. Provider business mailing address

84 PROFESSIONAL PKWY
TROY MO
63379-2822
US

V. Phone/Fax

Practice location:
  • Phone: 636-462-2110
  • Fax: 636-528-7361
Mailing address:
  • Phone: 636-462-2110
  • Fax: 636-528-7361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberT02474
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberT02474
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: