Individual
DR. RANDALL NACKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1400 HWY 61 SOUTH, SUITE 130, CRYSTAL CITY, MO 63019
(636) 937-8855
(636) 931-6561
Mailing address
PO BOX 13, CRYSTAL CITY, MO 63019
(636) 937-8855
(636) 931-6561
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
TP10024907
TX
Other
Enumeration date
08/16/2006
Last updated
02/19/2008
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