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General NPI Number Information
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NPI Number | 1881688125
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Entity Type | Organization
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Legal Business Name | FORSIGHT EYECARE LLC
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Dates
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Enumeration Date | 09/01/2005
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Last Update Date | 01/05/2009
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Provider Practice Location Address
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Address Line | 883 FAIRWAY DR
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City | CHILLICOTHEE
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State | MO
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Zip | 64601-3673
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Country | US
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Telephone | 660-707-0600
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Fax | 660-707-0611
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Provider Business Mailing Address
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Address Line | 883 FAIRWAY DR
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City | CHILLICOTHEE
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State | MO
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Zip | 64601-3673
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Country | US
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Telephone | 660-707-0600
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Fax | 660-707-0611
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Authorized Official
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Title or Position | DR/OWNER
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Name | MR. DAVID C HOEL
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Credential | OD
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Telephone | 660-707-0600
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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 | 2000146279
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License Number State | MO
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