Provider Demographics
NPI:1821132085
Name:HUNTRESS EYE CARE ASSOCIATES OPTOMETRISTS, P.C.
Entity Type:Organization
Organization Name:HUNTRESS EYE CARE ASSOCIATES OPTOMETRISTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:WASHECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-235-2020
Mailing Address - Street 1:215 4TH ST
Mailing Address - Street 2:P.O. BOX 460
Mailing Address - City:MONETT
Mailing Address - State:MO
Mailing Address - Zip Code:65708-2314
Mailing Address - Country:US
Mailing Address - Phone:417-235-2020
Mailing Address - Fax:417-235-5508
Practice Address - Street 1:215 4TH ST
Practice Address - Street 2:
Practice Address - City:MONETT
Practice Address - State:MO
Practice Address - Zip Code:65708-2314
Practice Address - Country:US
Practice Address - Phone:417-235-2020
Practice Address - Fax:417-235-5508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOTO2905152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO312853807Medicaid
MO313604001Medicaid
MO001007219Medicare ID - Type Unspecified
MO312853807Medicaid
MO002007219Medicare ID - Type Unspecified
MOU02327Medicare UPIN
0994710001Medicare NSC