MEDICARE: DR. STEVEN D. CANTRELL 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	152W00000X	Optometrist	TO 2222	MO

General Provider Information

NPI Number	:	1992828834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN D. CANTRELL O.D.

Provider Business Mailing Address
First Line	:	7511 BIG BEND BLVD
Second Line	:
City	:	WEBSTER GROVES
State	:	MO
Zip	:	63119-2103
Country	:	US
Telephone Number	:	314-961-7511
Fax Number	:	314-961-6759

Provider Business Practice Location Address
First Line	:	7511 BIG BEND BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63119-2103
Country	:	US
Telephone Number	:	314-961-7511
Fax Number	:	314-961-6759

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

Provider Enumeration Date	:	04/07/2007
Last Update Date	:	06/21/2016

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