Organization
PRIMARY EYE CARE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MERRILL THOMAS MILLER O.D. (OWNER)
(573) 888-5896
Entity
Organization
Contact information
Practice address
303 TEACO RD, KENNETT, MO 63857-3237
(573) 888-5896
(573) 888-1501
Mailing address
303 TEACO RD, KENNETT, MO 63857-3237
(573) 888-5896
(573) 888-1501
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
T02701
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
191843
BLUE CROSS BLUE SHIELD
MO
01
—
5514370001
CIGNA GOVERNMENT
MO
Enumeration date
01/30/2007
Last updated
08/22/2020
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