Provider Demographics
NPI:1245015973
Name:FRANZ, HAVEN LOUISE (OD)
Entity type:Individual
Prefix:
First Name:HAVEN
Middle Name:LOUISE
Last Name:FRANZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:HAVEN
Other - Middle Name:LOUISE
Other - Last Name:RICHARDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:9015 EAGER RD APT 355
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63144-1155
Mailing Address - Country:US
Mailing Address - Phone:618-895-4431
Mailing Address - Fax:
Practice Address - Street 1:1529 S OLD HIGHWAY 94 STE 120
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-3707
Practice Address - Country:US
Practice Address - Phone:636-949-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-30
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1087152W00000X
TN3842152W00000X
MO2024015892152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist