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General NPI Number Information
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NPI Number | 1659592160
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Entity Type | Organization
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Legal Business Name | DANIEL D SEIBERT OD PC
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 03/09/2011
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Provider Practice Location Address
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Address Line | 2040 WOODSON RD SUITE 100
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City | OVERLAND
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State | MO
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Zip | 63114-5644
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Country | US
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Telephone | 314-427-1519
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Fax |
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Provider Business Mailing Address
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Address Line | 2040 WOODSON RD SUITE 100
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City | OVERLAND
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State | MO
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Zip | 63114-5644
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANIEL D SEIBERT
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Credential | OD
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Telephone | 314-427-1519
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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 | T02387
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License Number State | MO
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