Individual
DONALD J VANDERFELTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O. D.
Contact information
Practice address
202 E NORTH ST, CALIFORNIA, MO 65018-1583
(573) 796-2222
(573) 796-4184
Mailing address
202 E NORTH ST, P. O. BOX 246, CALIFORNIA, MO 65018-1583
(573) 796-2222
(573) 796-4184
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T02337
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109091
BLUE CROSS BLUE SHIELD
MO
01
—
123785
HEALTHLINK
MO
01
—
22-00862
UNITED HEALTHCARE
MO
05
—
310208921
—
MO
01
—
T42545
MERCY HEALTH
MO
Enumeration date
08/12/2006
Last updated
02/20/2008
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