Provider Demographics
NPI:1447225867
Name:FINKLANG, KURT WALTER (OD)
Entity Type:Individual
Prefix:DR
First Name:KURT
Middle Name:WALTER
Last Name:FINKLANG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 PROFESSIONAL PKWY
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MO
Mailing Address - Zip Code:63379-2822
Mailing Address - Country:US
Mailing Address - Phone:636-462-2110
Mailing Address - Fax:636-528-7361
Practice Address - Street 1:84 PROFESSIONAL PKWY
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MO
Practice Address - Zip Code:63379-2822
Practice Address - Country:US
Practice Address - Phone:636-462-2110
Practice Address - Fax:636-528-7361
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOT02474152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO311616320Medicaid
MO311616320Medicaid
MO91197Medicare PIN