Organization
PAIGE HEDGPATH O.D,P.C.
Active
Other names
Eyes On Missouri
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CATHY L. SHORT (CREDENTIALING MANAGER)
(800) 407-2696
Entity
Organization
Contact information
Practice address
1709 MISSOURI BOULEVARD, SUITE IJK, JEFFERSON CITY, MO 65109
(573) 635-1313
(800) 432-6004
Mailing address
PO BOX 517, ALTON, IL 62002-0517
(618) 462-9818
(800) 432-6004
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013072966
MEDICARE
MO
01
—
1376601484
MEDICARE
MO
01
—
14072
SPECTERA
—
01
—
1669441630
MEDICARE
MO
01
—
1962644732
MEDICARE
MO
01
—
MA1757
MEDICARE
MO
01
—
MA1757001
MEDICARE
MO
01
—
MA1757002
MEDICARE
MO
Enumeration date
12/04/2006
Last updated
06/27/2024
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