Individual
DR. GARY WAYNE DELANCEY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
113 OLD STATE RD, SUITE 101, ELLISVILLE, MO 63021-2042
(636) 256-7800
(636) 394-1011
Mailing address
113 OLD STATE RD, SUITE 101, ELLISVILLE, MO 63021-2042
(636) 256-7800
(636) 394-1011
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
T02255
MO
152WC0802X
Corneal and Contact Management Optometrist
Primary
T02255
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100813
BLUE CROSS
—
01
—
114194
COLE
—
01
—
12922
SPECTERA
—
01
—
262074
NVA
—
01
—
26258
AVESIS
—
01
—
5615221
AETNA
—
01
—
T02255
VBA
—
01
—
VP13561
VCA
—
Enumeration date
11/03/2005
Last updated
09/11/2025
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