Daniel Novack, O.D.
Individual provider Active NPI Optometrist · Richmond, MO
NPI 1740569656 · NPPES record last updated Aug 9, 2011
Key facts
- NPI
- 1740569656
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 2011022945 (MO)
- Practice address
- 908 Walton Way
Richmond, MO 64085-2193 - Phone
- (816) 776-6918
- Fax
- (816) 776-7695
- NPI assigned
- Aug 9, 2011
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2011022945 | MO | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Novack Vision Care, LLC | Optometrist | Current |
Accepting new patients |
Locations
1166 W 103rd St
Kansas City, MO 64114
Phone (816) 941-6886
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2011022945 | MO | Yes |
Addresses
Primary practice location
908 Walton Way
Richmond, MO 64085-2193
Mailing address
908 Walton Way
Richmond, MO 64085-2193
Phone (816) 776-6918
Other providers in Richmond, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2011. 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.