Organization
CLARKSON OPTOMETRY MIDWEST INC
Active
Other names
Clarkson Eyecare
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES WACHTER (CMO)
(636) 200-4393
Entity
Organization
Contact information
Practice address
325 E LEWIS AND CLARK PKWY STE 200, CLARKSVILLE, IN 47129-1725
(636) 200-4393
(636) 527-0766
Mailing address
PO BOX 207170, DALLAS, TX 75320-7156
(636) 200-4393
(636) 527-0766
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200312790A
—
IN
05
—
77903979
—
KY
Enumeration date
06/01/2006
Last updated
05/25/2022
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