MEDICARE: DANIEL D SEIBERT OD PC

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	T02387	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	990001715	OTHER	MO	GROUP 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
2	1659592160	OTHER	MO	GROUP NPI
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	1962481390	OTHER	MO	NPI DR SEIBERT
6	1659487387	OTHER	MO	NPI DR ALEXANDEER HARRIS

General Provider Information

NPI Number	:	1659592160
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANIEL D SEIBERT OD PC

Provider Business Mailing Address
First Line	:	2040 WOODSON RD
Second Line	:	SUITE 100
City	:	OVERLAND
State	:	MO
Zip	:	63114-5644
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2040 WOODSON RD
Second Line	:	SUITE 100
City	:	OVERLAND
State	:	MO
Zip	:	63114-5644
Country	:	US
Telephone Number	:	314-427-1519
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DANIEL D SEIBERT
Credential	:	OD
Telephone Number	:	314-427-1519

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	03/09/2011

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