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NPI Code Detail

MEDICARE: OREAR OPTOMETRY P C

MEDICARE: OREAR OPTOMETRY P C
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
1152W00000XOptometristTO3218MO

General Provider Information

NPI Number : 1588993661
Entity Type Code : Organization
Provider Name (Legal Business Name) : OREAR OPTOMETRY P C
Provider Business Mailing Address
First Line : 1027 PORTER WAGONER BLVD STE 300
Second Line :
City : WEST PLAINS
State : MO
Zip : 65775-2101
Country : US
Telephone Number : 417-255-0425
Fax Number :
Provider Business Practice Location Address
First Line : 1310 PREACHER ROE BLVD
Second Line :
City : WEST PLAINS
State : MO
Zip : 65775-2938
Country : US
Telephone Number : 417-255-0425
Fax Number : 417-257-2815
Authorized Official
Title or Position : PRESIDENT
Name : DR. STACY LEE OREAR
Credential : O. D.
Telephone Number : 417-255-0425
Provider Enumeration Date : 12/18/2009
Last Update Date : 12/18/2009

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Directions to “OREAR OPTOMETRY P C ” Practice Location

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