Individual
DR. PAUL ALAN WHITTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
875 SAINT FRANCOIS ST, FLORISSANT, MO 63031-4923
(314) 839-2400
(314) 839-2403
Mailing address
823 DUTCH MILL, BALLWIN, MO 63011-3545
(314) 766-7047
(314) 839-2403
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2000160792
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109862A
BLUECROSS / BLUESHIELD
MO
05
—
315059105
—
MO
01
—
P00328959
RAILROAD MEDICARE
MO
Enumeration date
10/07/2005
Last updated
02/10/2014
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