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Individual

DR. MATTHEW BLAIR MCCOY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1229 E SEMINOLE ST STE 430, SPRINGFIELD, MO 65804-2227
(417) 820-9393
Mailing address
1229 E SEMINOLE ST STE 430, SPRINGFIELD, MO 65804-2227
(417) 820-9393

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
1779
SC
152W00000X
Optometrist
1929DT
KY
152W00000X
Optometrist
Primary
2018040909
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
D17792
SC
Enumeration date
07/24/2013
Last updated
11/19/2018
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