Provider Demographics
NPI:1013998707
Name:MCGUIRE, DOUGLAS J (OD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:J
Last Name:MCGUIRE
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:5496 BAUMGARTNER RD
Mailing Address - Street 2:S.105
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63129-2834
Mailing Address - Country:US
Mailing Address - Phone:314-487-2600
Mailing Address - Fax:314-487-7135
Practice Address - Street 1:5496 BAUMGARTNER RD
Practice Address - Street 2:S.105
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63129-2834
Practice Address - Country:US
Practice Address - Phone:314-487-2600
Practice Address - Fax:314-487-7135
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOT-03075152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOU78412Medicare UPIN