Individual
JEFFREY M GAMBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
500 KEENE ST, SUITE 103, COLUMBIA, MO 65201-8104
(573) 874-2030
(573) 449-0253
Mailing address
500 KEENE ST, SUITE 103, COLUMBIA, MO 65201-8104
(573) 874-2030
(573) 449-0253
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2002015315
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0270770001
NORIDIAN-DMERC
MO
01
—
176950
BC/BS
MO
05
—
315958306
—
MO
01
—
P00221762
RAILROAD MEDICARE
MO
01
—
P00401206
RAILROAD MEDICARE
MO
Enumeration date
05/23/2006
Last updated
06/24/2009
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