Provider Demographics
NPI:1225086150
Name:STROUD, JOYCE KELLER (OD)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:KELLER
Last Name:STROUD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:
Other - Last Name:SCHIERMEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:2925 N BELT HWY
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-2006
Mailing Address - Country:US
Mailing Address - Phone:816-364-0450
Mailing Address - Fax:816-364-0487
Practice Address - Street 1:2925 N BELT HWY
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-2006
Practice Address - Country:US
Practice Address - Phone:816-364-0450
Practice Address - Fax:816-364-0487
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOTO2602152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOK550295Medicare ID - Type Unspecified
MOT81783Medicare UPIN