MEDICARE: WM F KIEFER & ASSOCIATES INC

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	T02269	MO

General Provider Information

NPI Number	:	1942259551
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WM F KIEFER & ASSOCIATES INC

Provider Business Mailing Address
First Line	:	4305 BUTLER HILL RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63128-3717
Country	:	US
Telephone Number	:	314-487-4744
Fax Number	:	314-845-5956

Provider Business Practice Location Address
First Line	:	4305 BUTLER HILL RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63128-3717
Country	:	US
Telephone Number	:	314-487-4744
Fax Number	:	314-845-5956

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. WILLIAM F KIEFER JR.
Credential	:	O.D.
Telephone Number	:	314-487-4744

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	01/31/2008

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