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General NPI Number Information
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NPI Number | 1275265209
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Entity Type | Individual
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Provider Name | RACHEL SULLIVAN PEYTON OD
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Gender | Female
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Dates
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Enumeration Date | 06/28/2022
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Last Update Date | 07/06/2022
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Provider Practice Location Address
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Address Line | 84 PROFESSIONAL PKWY
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City | TROY
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State | MO
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Zip | 63379-2822
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Country | US
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Telephone | 636-528-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 84 PROFESSIONAL PKWY
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City | TROY
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State | MO
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Zip | 63379-2822
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Country | US
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Telephone | 636-528-2020
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Fax | 636-528-7361
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2022024193
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License Number State | MO
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