Individual
DR. DESMON PAIGE CARL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1200 WINCHESTER DR, SEDALIA, MO 65301-2467
(660) 826-2642
Mailing address
2804 BRANDON AVE, SEDALIA, MO 65301-6892
(660) 829-0067
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2004017484
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
318400314
—
MO
Enumeration date
06/15/2005
Last updated
04/28/2010
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