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General NPI Number Information
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NPI Number | 1780745166
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Entity Type | Individual
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Provider Name | RICK W MCMURTREY O.D.
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Gender | Male
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2300 BERNADETTE DR STE 804 COLUMBIA MALL
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City | COLUMBIA
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State | MO
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Zip | 65203-4607
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Country | US
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Telephone | 573-445-1766
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Fax | 573-446-6469
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Provider Business Mailing Address
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Address Line | 2300 BERNADETTE DR STE 804 COLUMBIA MALL
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City | COLUMBIA
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State | MO
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Zip | 65203-4607
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Country | US
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Telephone | 573-445-1766
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Fax | 573-446-6469
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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 | T02857
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License Number State | MO
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