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Individual

DR. MARY C. HOHENBERGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
935 N HIGHWAY 67, FLORISSANT, MO 63031-2917
(314) 838-7644
(800) 432-6004
Mailing address
211 E BROADWAY, ALTON, IL 62002-6220
(618) 462-9818
(800) 432-6004

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
046-008348
IL
152W00000X
Optometrist
Primary
TO2898
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000091342
MEDICARE PART B
MO
01
108046
BLUE CROSS BLUE SHIELD OF
MO
01
110973
EYEMED
MO
01
215634
GHP
01
22-02300
UNITED HEALTHCARE
MO
01
22-02300
OPTICARE MEDICARE COMPLET
05
313059206
MO
05
313059214
MO
01
382671
HEALTHLINK
01
410048082
RR MEDICARE
IL
01
4182
HEALTHCARE USA
MO
01
P00402868
RR MEDICARE
MO
Enumeration date
03/07/2006
Last updated
04/21/2017
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