Joel Francis Allison, O.D.
Individual provider Active NPI Optometrist · Jackson, MO
NPI 1962664151 · NPPES record last updated Jun 28, 2008
Key facts
- NPI
- 1962664151
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- T03308 (MO)
- Practice address
- 3051 E Jackson Blvd
Jackson, MO 63755-2910 - Phone
- (573) 204-7301
- Fax
- (573) 204-7304
- NPI assigned
- Jun 28, 2008
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|
| T03308 | MO | MD | Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | T03308 | MO | Yes |
Addresses
Primary practice location
3051 E Jackson Blvd
Jackson, MO 63755-2910
Mailing address
3051 E Jackson Blvd
Jackson, MO 63755-2910
Phone (573) 204-7301
Other providers in Jackson, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2008. 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.