Medro Joseph Brodeur III, O.D., P.C.
Organization Active NPI Optometrist · Gerald, MO
NPI 1013227370 · NPPES record last updated Oct 20, 2010
Key facts
- NPI
- 1013227370
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- TO2435 (MO)
- Legal business name
- MEDRO JOSEPH BRODEUR III, O.D., P.C.
- Practice address
- 356 S Main St
Gerald, MO 63037-2270 - Phone
- (573) 764-2177
- NPI assigned
- Oct 20, 2010
- Organization subpart
- No
Authorized official
- Name
- Dr. Medro Joseph Brodeur III, O.D
- Title
- Owner
- Phone
- (573) 764-2177
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | TO2435 | MO | Yes |
Addresses
Primary practice location
356 S Main St
Gerald, MO 63037-2270
Mailing address
356 S Main St
Box 81
Gerald, MO 63037-2270
Phone (573) 764-2177
Other providers in Gerald, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 20, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.