Provider Demographics
NPI:1831179670
Name:KOVACS, BERNARD M (OD)
Entity type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:M
Last Name:KOVACS
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:13 MEADOW LAKE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-5468
Mailing Address - Country:US
Mailing Address - Phone:314-432-5319
Mailing Address - Fax:
Practice Address - Street 1:176 CRESTWOOD PLZ
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63126-1701
Practice Address - Country:US
Practice Address - Phone:314-968-3660
Practice Address - Fax:314-968-3559
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2003020949152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO183966OtherBCBS OF MISSOURI
MO567053OtherHEALTHLINK
MO183966OtherBCBS OF MISSOURI