Provider Demographics
NPI:1689643249
Name:HEGYI, LAURA M (OD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:M
Last Name:HEGYI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:40 E NORTH ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:MO
Mailing Address - Zip Code:63025-1205
Mailing Address - Country:US
Mailing Address - Phone:636-200-4393
Mailing Address - Fax:636-938-2650
Practice Address - Street 1:227 SALT LICK RD
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-5974
Practice Address - Country:US
Practice Address - Phone:636-970-0250
Practice Address - Fax:636-276-1061
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004030856152W00000X
IN18003019152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1689643249Medicaid
MOMA5227018Medicare UPIN
MO1689643249Medicaid
MO064380023Medicare PIN