Provider Demographics
NPI:1821066903
Name:METZGER, JOHN C (OD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:METZGER
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 1:10875 GRANDVIEW DRIVE
Mailing Address - Street 2:SUITE 2260
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1571
Mailing Address - Country:US
Mailing Address - Phone:913-469-8686
Mailing Address - Fax:913-469-8688
Practice Address - Street 1:10875 GRANDVIEW DRIVE
Practice Address - Street 2:SUITE 2260
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1571
Practice Address - Country:US
Practice Address - Phone:913-469-8686
Practice Address - Fax:913-469-8688
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE829152W00000X
KS1105152W00000X, 152WL0500X, 152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
No152W00000XEye and Vision Services ProvidersOptometrist
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS480942453OtherTRICARE/TRIWEST
KS462239OtherFAMILY HEALTH PARTNERS
NE48094245300Medicaid
KS651144OtherBLUE CROSS BLUE SHIELD
KSP00074185OtherPALMETTO GBA
KS100090510AMedicaid
KS0367280001Medicare NSC
KS651144OtherBLUE CROSS BLUE SHIELD
KSP00074185OtherPALMETTO GBA