Provider Demographics
NPI:1275671588
Name:LEONARD HUGHES CO INC
Entity Type:Organization
Organization Name:LEONARD HUGHES CO INC
Other - Org Name:WEBSTER VISION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:D
Authorized Official - Last Name:BECKHAM
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:314-961-1211
Mailing Address - Street 1:8456 WATSON RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63119-5217
Mailing Address - Country:US
Mailing Address - Phone:314-961-1211
Mailing Address - Fax:314-961-4053
Practice Address - Street 1:8456 WATSON RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63119-5217
Practice Address - Country:US
Practice Address - Phone:314-961-1211
Practice Address - Fax:314-961-4053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO320813801Medicaid
MO000009318OtherMEDICARE PTAN
MO320813801Medicaid