Provider Demographics
NPI:1811039910
Name:UNSELL, RICK JON (OD)
Entity Type:Individual
Prefix:DR
First Name:RICK
Middle Name:JON
Last Name:UNSELL
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 1:7436 NW RIVER PARK DR
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64152-5028
Mailing Address - Country:US
Mailing Address - Phone:816-587-7327
Mailing Address - Fax:
Practice Address - Street 1:7436 NW RIVER PARK DR
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MO
Practice Address - Zip Code:64152-5028
Practice Address - Country:US
Practice Address - Phone:816-587-7327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOT02278152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y321997Medicare PIN
MOT42500Medicare UPIN