MEDICARE: ROBERT M. PALMER, O.D., 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
1	152W00000X	Optometrist	T02346	MO

General Provider Information

NPI Number	:	1841278462
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT M. PALMER, O.D., P.C.

Provider Business Mailing Address
First Line	:	215 S STURGEON ST
Second Line	:	SUITE A
City	:	MONTGOMERY CITY
State	:	MO
Zip	:	63361-2558
Country	:	US
Telephone Number	:	573-564-3877
Fax Number	:	573-564-3515

Provider Business Practice Location Address
First Line	:	215 S STURGEON ST
Second Line	:	SUITE A
City	:	MONTGOMERY CITY
State	:	MO
Zip	:	63361-2558
Country	:	US
Telephone Number	:	573-564-3877
Fax Number	:	573-564-3515

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT M PALMER
Credential	:	O.D.
Telephone Number	:	573-564-3877

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	08/15/2008

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