Eyecare Of Boonville, Llc | |
505 E Walnut St, Boonville, MO 65233-1665 | |
(660) 882-2444 | |
Not Available |
Full Name | Eyecare Of Boonville, Llc |
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Type | Facility |
Speciality | Optometrist |
Location | 505 E Walnut St, Boonville, Missouri |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1669664280 | NPI | - | NPPES |
219840 | Other | MO | ANTHEM PROVIDER ID |
Taxonomy | Type | License (State) | Status |
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152W00000X | Optometrist | 2004017361 (Missouri) | Primary |
Provider Name | Jeffery Birdsong |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1790777191 PECOS PAC ID: 2567424013 Enrollment ID: I20041028000038 |
Mailing Address | Practice Location Address |
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Eyecare Of Boonville, Llc 505 E Walnut St, Boonville, MO 65233-1665 Ph: (660) 882-2444 | Eyecare Of Boonville, Llc 505 E Walnut St, Boonville, MO 65233-1665 Ph: (660) 882-2444 |
Mr. Stephen F Enochs, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 505 E Walnut St, Boonville, MO 65233 Phone: 660-882-2741 Fax: 660-882-7976 | |
Jeff Birdsong, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 505 E Walnut St, Boonville, MO 65233 Phone: 660-882-2444 Fax: 660-882-7976 |