MEDICARE: DR. RAYMOND FADA JR. O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	T02848	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	410035943	OTHER	MO	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013913094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAYMOND FADA JR. O.D.

Provider Business Mailing Address
First Line	:	40 E NORTH ST
Second Line	:
City	:	EUREKA
State	:	MO
Zip	:	63025-1205
Country	:	US
Telephone Number	:	636-200-4393
Fax Number	:	636-938-2650

Provider Business Practice Location Address
First Line	:	6157 MID RIVERS MALL DR
Second Line	:	202
City	:	SAINT PETERS
State	:	MO
Zip	:	63304-1105
Country	:	US
Telephone Number	:	636-926-3647
Fax Number	:	636-926-3684

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	11/18/2014

Similar Medicare Providers

1013913185 — DR. PAMELA COSLICK O.D.
Practice Location Address:

6157 MID RIVERS MALL DR
SAINT PETERS, MO
63304-1105

Practice Phone: 636-926-3647
Practice Fax: 636-926-3684

1053346395 — DR. RYAN ANTHONY SWIER D.C.
Practice Location Address:

6179 MID RIVERS MALL DR
SAINT PETERS, MO
63304-1105

Practice Phone: 636-939-5500
Practice Fax: 636-939-5500

1902826167 — DR. JAY DOUGLAS BROWN DMD
Practice Location Address:

6141 MID RIVERS MALL DR
SAINT PETERS, MO
63304-1105

Practice Phone: 636-441-4600
Practice Fax: 636-922-2094

1548467798 — BLAIRE SHAREE O'BRIEN O.D.
Practice Location Address:

6157 MID RIVERS MALL DR
SAINT PETERS, MO
63304-1105

Practice Phone: 636-926-3647
Practice Fax: 636-926-3684

1790927507 — CLARKSON OPTOMETRY INC
Practice Location Address:

6157 MID RIVERS MALL DR
SAINT PETERS, MO
63304-1105

Practice Phone: 636-200-4393
Practice Fax: 636-926-3684

1609491422 — ARIC JOSEPH WALTZ OD
Practice Location Address:

6157 MID RIVERS MALL DR
SAINT PETERS, MO
63304-1105

Practice Phone: 636-200-4393
Practice Fax:

Directions to “ DR. RAYMOND FADA JR. O.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.