Provider Demographics
NPI:1639421092
Name:PAMELA K. WARBINTON, OD, LLC
Entity Type:Organization
Organization Name:PAMELA K. WARBINTON, OD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:K
Authorized Official - Last Name:WARBINTON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:417-837-4004
Mailing Address - Street 1:2009 ANDRAE RD
Mailing Address - Street 2:
Mailing Address - City:WEBB CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64870-9237
Mailing Address - Country:US
Mailing Address - Phone:417-837-4004
Mailing Address - Fax:417-875-4710
Practice Address - Street 1:2009 ANDRAE RD
Practice Address - Street 2:
Practice Address - City:WEBB CITY
Practice Address - State:MO
Practice Address - Zip Code:64870-9237
Practice Address - Country:US
Practice Address - Phone:417-837-4004
Practice Address - Fax:417-875-4710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-10
Last Update Date:2017-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOT02424152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty