MEDICARE: DR. JERRI L BIRSINGER 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	152WC0802X	Corneal and Contact Management Optometrist	T03357	MO
2	152WP0200X	Pediatric Optometrist	T03357	MO
3	152W00000X	Optometrist	T03357	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	BLC38016	OTHER	MO	BLUE CHOICE
2	410053835	OTHER	MO	PALMETTO GBA RAILROAD MED
3	108559	OTHER	MO	BC/BS ALLIANCE
4	342121	OTHER	MO	HEALTHLINK
5	60054	OTHER	MO	AETNA
6	114488	OTHER	MO	BLUE CROSS/ BLUE SHIELD
7	22-02004	OTHER	MO	UNITED HEALTHCARE
8	401501	OTHER	MO	GROUP HEALTH PLAN

General Provider Information

NPI Number	:	1760474662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JERRI L BIRSINGER O.D.

Provider Business Mailing Address
First Line	:	1781 JEFFCO BLVD
Second Line	:
City	:	ARNOLD
State	:	MO
Zip	:	63010-2713
Country	:	US
Telephone Number	:	636-200-5008
Fax Number	:	636-333-3093

Provider Business Practice Location Address
First Line	:	1781 JEFFCO BLVD
Second Line	:
City	:	ARNOLD
State	:	MO
Zip	:	63010-2713
Country	:	US
Telephone Number	:	636-200-5008
Fax Number	:	636-333-3093

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

Provider Enumeration Date	:	08/17/2005
Last Update Date	:	11/13/2023

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Directions to “ DR. JERRI L BIRSINGER O.D.” Practice Location

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