Gennadiy Dameshek, OD | |
126 S Main St, De Soto, MO 63020-2104 | |
(636) 586-5406 | |
Not Available |
Full Name | Gennadiy Dameshek |
---|---|
Gender | Male |
Speciality | Optometrist |
Location | 126 S Main St, De Soto, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1871799106 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 2006020342 (Missouri) | Primary |
152W00000X | Optometrist | 046.009981 (Illinois) | Secondary |
Provider Name | Vep Il Optometric Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1528536620 PECOS PAC ID: 3678814217 Enrollment ID: O20190409002694 |
Mailing Address | Practice Location Address |
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Gennadiy Dameshek, OD 126 S Main St, De Soto, MO 63020-2104 Ph: (636) 586-5406 | Gennadiy Dameshek, OD 126 S Main St, De Soto, MO 63020-2104 Ph: (636) 586-5406 |
Renee Kathleen Lane, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 12862 State Route 21, De Soto, MO 63020 Phone: 636-586-9745 Fax: 636-586-0901 | |
De Soto Eye Care Llc Optometrist Medicare: Medicare Enrolled Practice Location: 126 S Main St, De Soto, MO 63020 Phone: 636-586-5406 Fax: 636-586-1969 | |
Thomas L. Monje, O.d. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 26 Jefferson Sq, De Soto, MO 63020 Phone: 636-586-2626 Fax: 636-586-2700 |