Individual
MARK ANTHONY HERRIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1253-2
KS
152W00000X
Optometrist
Primary
T-02710
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100218260A
—
KS
01
—
13232012
BLUE CROSS BLUE SHIELD OF KANSAS CITY
MO
01
—
13232032
BLUE CROSS BLUE SHIELD OF KANSAS CITY
KS
01
—
410014216
RAILROAD MEDICARE
KS
01
—
410038121
MEDICARE RR
MO
01
—
5797073B
MEDICARE ID - UNSPECIFIED
MO
01
—
650868
MEDICARE ID-TYPE UNSPECIFIED
KS
01
—
DQ3063
RAILROAD MEDICARE
KS
01
—
KA1721002
MEDICARE ID-TYPE UNSPECIFIED
KS
01
—
P00830626
RAILROAD MEDICARE
KS
Enumeration date
07/12/2005
Last updated
10/14/2020
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