Provider Demographics
NPI:1619385291
Name:PIKE, EMILY VICTORIA (OD, MPH)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:VICTORIA
Last Name:PIKE
Suffix:
Gender:F
Credentials:OD, MPH
Other - Prefix:
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Mailing Address - Street 1:15933 CLAYTON RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63011-2172
Mailing Address - Country:US
Mailing Address - Phone:636-200-4393
Mailing Address - Fax:636-527-0766
Practice Address - Street 1:917 OLIVE ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63101-1418
Practice Address - Country:US
Practice Address - Phone:314-621-5303
Practice Address - Fax:314-621-7011
Is Sole Proprietor?:No
Enumeration Date:2014-07-28
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2014020357152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist