Organization
ADVANCED EYECARE, PC
Active
Other names
Advanced Eyecare South
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD C WILSON OD (OWNER)
(816) 353-1872
Entity
Organization
Contact information
Practice address
905 W FOXWOOD DR, RAYMORE, MO 64083-7200
(816) 322-1872
Mailing address
905 W FOXWOOD DR, RAYMORE, MO 64083-7200
(816) 322-1872
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DG 2866
RAILROAD MEDICARE
MO
Enumeration date
09/15/2010
Last updated
04/15/2019
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