Organization
T M SWINGER & D V MCKILLIP, PTR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKIE L HURLEY (OFFICE MANAGER)
(573) 379-5235
Entity
Organization
Contact information
Practice address
306 KING AVE, PORTAGEVILLE, MO 63873-1441
(573) 379-5235
Mailing address
306 KING AVE, PORTAGEVILLE, MO 63873-1441
(573) 379-5235
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T02167
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0279400002
NSC MEDICARE
MO
05
—
310150404
—
MO
01
—
410027250
RAILROAD MEDICARE
MO
Enumeration date
01/09/2008
Last updated
07/10/2013
Update your record
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