Organization
OTIS OPTOMETRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATT DAVID WICKHAM O.D. (OWNER)
(314) 276-1228
Entity
Organization
Contact information
Practice address
94 CECIL ST, CAMDENTON, MO 65020-7057
(573) 317-9279
(888) 841-1312
Mailing address
1939 WENTZVILLE PKWY, STE 166, WENTZVILLE, MO 63385-3424
(636) 812-3821
(888) 841-1312
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TO3134
MO
Other
Enumeration date
05/12/2014
Last updated
07/29/2014
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up