Provider Demographics
NPI:1093975153
Name:WATERS, AMY (OD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:
Last Name:WATERS
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:2401 GILLHAM RD
Mailing Address - Street 2:DEPT OF OPHTHALMOLOGY
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-4619
Mailing Address - Country:US
Mailing Address - Phone:816-960-8000
Mailing Address - Fax:816-960-8041
Practice Address - Street 1:2401 GILLHAM RD
Practice Address - Street 2:DEPT OF OPHTHALMOLOGY
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-4619
Practice Address - Country:US
Practice Address - Phone:816-234-3046
Practice Address - Fax:816-855-1793
Is Sole Proprietor?:No
Enumeration Date:2008-06-12
Last Update Date:2013-08-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2007023892152WP0200X
KS1778152WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WP0200XEye and Vision Services ProvidersOptometristPediatrics