| |
302 Procter Rd, Willard, MO 65781-9144 | |
(417) 742-2733 | |
(417) 742-2237 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 302 Procter Rd, Willard, Missouri |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1871751974 | NPI | - | NPPES |
317178408 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 2005020864 (Missouri) | Primary |
Provider Name | Devon Paul Jarvis |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1124069208 PECOS PAC ID: 6901839786 Enrollment ID: I20050913000358 |
Mailing Address | Practice Location Address |
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302 Procter Rd, Willard, MO 65781-9144 Ph: (508) 837-3790 | 302 Procter Rd, Willard, MO 65781-9144 Ph: (417) 742-2733 |
Dr. Devon Paul Jarvis, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 302 Procter Rd, Willard, MO 65781 Phone: 417-742-2733 Fax: 417-742-2237 |