| Richard C Wilson, OD | |
|
6708 Raytown Rd, Raytown, MO 64133-5272 | |
| (816) 353-1872 | |
| (816) 353-5022 |
| Full Name | Richard C Wilson |
|---|---|
| Gender | Male |
| Speciality | Optometrist |
| Location | 6708 Raytown Rd, Raytown, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538143540 | NPI | - | NPPES |
| 410037607 | Other | RAILROAD MEDICARE | |
| TO 3339 | Other | MO | LICENSE |
| KS 1674 | Other | KS | LICENSE |
| 312239309 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | TO 3339 (Missouri) | Primary |
| 152W00000X | Optometrist | KS 1674 (Kansas) | Secondary |
| Provider Name | Advanced Eyecare Pc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1679510655 PECOS PAC ID: 3870539232 Enrollment ID: O20050707000454 |
| Provider Name | Paige Hedgpath Odpc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1962644732 PECOS PAC ID: 5991856460 Enrollment ID: O20090623000274 |
| Mailing Address | Practice Location Address |
|---|---|
| Richard C Wilson, OD 6708 Raytown Rd, Raytown, MO 64133-5272 Ph: (816) 353-1872 | Richard C Wilson, OD 6708 Raytown Rd, Raytown, MO 64133-5272 Ph: (816) 353-1872 |
Dr. Lawrence D Reed, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 6708 Raytown Rd, Raytown, MO 64133 Phone: 816-353-1872 Fax: 816-353-5022 | |
Dr. Dana Janel Krause, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 6708 Raytown Rd, Raytown, MO 64133 Phone: 816-353-1872 Fax: 816-353-5022 | |
Charles A Banks, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 6708 Raytown Rd, Raytown, MO 64133 Phone: 816-353-1872 Fax: 816-353-5022 | |
Dr. Melanie Lynn Linderer, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 6708 Raytown Road, Raytown, MO 64133 Phone: 816-353-1872 Fax: 816-353-5022 | |
Dr. Christine L Mitts, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 6708 Raytown Rd, Raytown, MO 64133 Phone: 816-353-1872 | |
Dr. Steven L Padget, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 9507 E 63rd St, Suite 101, Raytown, MO 64133 Phone: 816-356-5520 Fax: 816-356-2150 | |
Dr. Melissa Marie Enevoldsen, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 6708 Raytown Rd, Raytown, MO 64133 Phone: 816-353-1872 |