Provider Demographics
NPI:1093032773
Name:GELNER OPTOMETRY, P.C.
Entity Type:Organization
Organization Name:GELNER OPTOMETRY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:VIRTUE
Authorized Official - Last Name:GELNER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:314-434-2626
Mailing Address - Street 1:14386 WOODLAKE DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-5714
Mailing Address - Country:US
Mailing Address - Phone:314-434-2626
Mailing Address - Fax:314-434-2631
Practice Address - Street 1:14386 WOODLAKE DR
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-5714
Practice Address - Country:US
Practice Address - Phone:314-434-2626
Practice Address - Fax:314-434-2631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO32331OtherBLUE CROSS
MO07144OtherSPECTERA
MO256594214OtherMEDICARE ID - TYPE UNSPECIFIED
MO325596OtherHEALTHLINK
MOMO2393OtherEYEMED
MOGE312309800Medicaid
MOGE312309800Medicaid