MJB Optical, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

T02825 Issued in MO

Legal business name

MJB OPTICAL, INC.

Doing business as

Main Street Eye Clinic

Practice address

3201 Highway 61
Hannibal, MO 63401-6578

Phone

(573) 248-3937

Fax

(573) 221-4393

NPI assigned

Feb 5, 2006

Last updated

Feb 26, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Matthew Joseph Bowman, O.D.NPI 1548232481

Title

President

Phone

(573) 248-3937

Specialties & licenses 1

Addresses

Other names 1

• Main Street Eye Clinic Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew Joseph Bowman, O.D.

  • Optometrist
  • Camdenton, MO
  • NPI 1548232481
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235606400000",
    "number": "1275505117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 HIGHWAY 61",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016578",
            "telephone_number": "573-248-3937",
            "fax_number": "573-221-4393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 HIGHWAY 61",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016578",
            "telephone_number": "573-248-3937",
            "fax_number": "573-221-4393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MJB OPTICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-05",
        "last_updated": "2009-02-26",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-248-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Main Street Eye Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jill Kay Miller, LCSW
• Danielle Elizabeth Mills, PA-C
• Jennifer Lynn Minoff, MD
• Elizabeth S. Minor, MOT
• Missouri CVS Pharmacy LLC (CVS Pharmacy# 10345)
• Cheryl Mobley, MEC, PLPC
• Elizabeth Marie Monroe, O.D.
• Angela M Montgomery
• Edwina Morriss-Hirner, LCSW, MSW
• Lisa Morrow, MA, LPC

• Optometrist in Hannibal, MO
• Providers in Hannibal, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.