| |
6313 Ronald Reagan Blvd, Lake Saint Louis, MO 63367-2659 | |
(636) 200-4393 | |
(636) 561-2362 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 6313 Ronald Reagan Blvd, Lake Saint Louis, Missouri |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1659682235 | NPI | - | NPPES |
000014545 | Other | MO | MEDICARE PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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Po Box 207158, Dallas, TX 75320-7158 Ph: (636) 200-4393 | 6313 Ronald Reagan Blvd, Lake Saint Louis, MO 63367-2659 Ph: (636) 200-4393 |
Dr. James Matthew Kirks, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 108 Brevco Plz, Lake Saint Louis, MO 63367 Phone: 636-561-6000 Fax: 636-625-0707 |