Individual
DR. PATRICIA R BOGAARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2001022272
MO
152W00000X
Optometrist
Primary
2163
AZ
152W00000X
Optometrist
622
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9203570
—
SD
01
—
G49B00001
MEDICARE PTAN
MO
Enumeration date
05/31/2006
Last updated
10/31/2025
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