Provider Demographics
NPI:1205856085
Name:DENNIS LEON HUNTER
Entity Type:Organization
Organization Name:DENNIS LEON HUNTER
Other - Org Name:MARSHALL EYE CARE CENTER,LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:660-886-5517
Mailing Address - Street 1:365 W MORGAN ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MO
Mailing Address - Zip Code:65340-1929
Mailing Address - Country:US
Mailing Address - Phone:660-886-5517
Mailing Address - Fax:660-886-5074
Practice Address - Street 1:365 W MORGAN ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MO
Practice Address - Zip Code:65340-1929
Practice Address - Country:US
Practice Address - Phone:660-886-5517
Practice Address - Fax:660-886-5074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOT02256152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOA600000Medicare ID - Type UnspecifiedGROUP