Robert M Broaddus, OD | |
13839 S Mur Len Rd Ste A, Olathe, KS 66062-1661 | |
(913) 782-5993 | |
Not Available |
Full Name | Robert M Broaddus |
---|---|
Gender | Male |
Speciality | Optometrist |
Location | 13839 S Mur Len Rd Ste A, Olathe, Kansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1326107350 | NPI | - | NPPES |
1591 | Other | KS | STATE LICENSE |
30592028 | Other | MO | BLUE CROSS BLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 1591 (Kansas) | Primary |
Provider Name | Windmill Eye Associates Pa |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1487706370 PECOS PAC ID: 0143275198 Enrollment ID: O20050910000116 |
Mailing Address | Practice Location Address |
---|---|
Robert M Broaddus, OD 13839 S Mur Len Rd Ste A, Olathe, KS 66062-1661 Ph: (913) 782-5993 | Robert M Broaddus, OD 13839 S Mur Len Rd Ste A, Olathe, KS 66062-1661 Ph: (913) 782-5993 |
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