Provider Demographics
NPI:1346211885
Name:HAROLD L POYNTER OD HL POYNTER OD PAUL R POYNTER OD OPTOMETRY INC
Entity Type:Organization
Organization Name:HAROLD L POYNTER OD HL POYNTER OD PAUL R POYNTER OD OPTOMETRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:L
Authorized Official - Last Name:POYNTER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:660-582-5222
Mailing Address - Street 1:503 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64468-2444
Mailing Address - Country:US
Mailing Address - Phone:660-582-5222
Mailing Address - Fax:660-582-6558
Practice Address - Street 1:503 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:MO
Practice Address - Zip Code:64468-2444
Practice Address - Country:US
Practice Address - Phone:660-582-5222
Practice Address - Fax:660-582-6558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-01
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOT02150152W00000X
MOT02237152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO4120852AMedicare PIN
MO4120000AMedicare PIN
MO4120711AMedicare PIN
T81816Medicare UPIN
T42519Medicare UPIN
MO0542010003Medicare NSC