Medro Joseph Brodeur III, O.D., P.C.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

TO2435 Issued in MO

Legal business name

MEDRO JOSEPH BRODEUR III, O.D., P.C.

Practice address

531 E Washington Ave
Owensville, MO 65066-1410

Phone

(573) 437-8004

Fax

(573) 437-8004

NPI assigned

Aug 24, 2007

Last updated

Feb 21, 2013By 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. Medro Joseph Brodeur III, O.D.NPI 1821068487

Title

Optometrist

Phone

(573) 437-8004

Specialties & licenses 1

Addresses

Locations

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.

• Medro Joseph Brodeur III, OD

  • Optometrist
  • Owensville, MO
  • NPI 1821068487
  Authorized official Same address or phone

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

{
    "created_epoch": "1187913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361404800000",
    "number": "1790978575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 E WASHINGTON AVE",
            "city": "OWENSVILLE",
            "state": "MO",
            "postal_code": "650661410",
            "telephone_number": "573-437-8004",
            "fax_number": "573-437-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 E WASHINGTON AVE",
            "city": "OWENSVILLE",
            "state": "MO",
            "postal_code": "650661410",
            "telephone_number": "573-437-8004",
            "fax_number": "573-437-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDRO JOSEPH BRODEUR III, O.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-24",
        "last_updated": "2013-02-21",
        "status": "A",
        "authorized_official_last_name": "BRODEUR",
        "authorized_official_first_name": "MEDRO",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "573-437-8004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MO",
            "license": "TO2435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anna Mincemeyer
• Sandra Kay Mitchell, PHARM. D.
• Joline Morgan
• Kary Mueller-Schansberg, PHD, LP
• Donna Nicks, RPT

• Eyewear Supplier in Owensville, MO
• Providers in Owensville, MO by specialty
• Eyewear Supplier in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; 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.