Clarkson Optometry Inc

Organization Active NPI Optometrist · Saint Louis, MO

NPI 1821040593 · NPPES record last updated Jul 5, 2019

Key facts

NPI
1821040593
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
Legal business name
CLARKSON OPTOMETRY INC
Practice address
2185 S Mason Rd
Saint Louis, MO 63131-1640
Phone
(636) 200-4393
Fax
(314) 821-5322
NPI assigned
May 17, 2006
Organization subpart
No

Authorized official

Name
James Wachter
Title
Cmo
Phone
(636) 200-4393

Other NPIs with the same Medicare PAC ID 16

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners 82

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 82

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20150310002439 MO DME Supplier - Physician - Optometrist 0840411799 Practice locations: Saint Louis, MO

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193400000X SINGLE SPECIALTY GROUP
152W00000X Yes

Addresses

Primary practice location

2185 S Mason Rd
Saint Louis, MO 63131-1640

Mailing address

PO Box 207158
Dallas, TX 75320-7158
Phone (636) 200-4393

Other identifiers

IdentifierTypeStateIssuer
7238350010OtherMODMERC

Other names

  • Clarkson Eyecare Doing business as

Other providers in Saint Louis, MO

All providers in Saint Louis, MO · Optometrist in Missouri

Sources for this page

Verify at the official NPI Registry.