Organization
BENNETT EYECARE MIDWEST LLC
Active
Parent organization
BENNETT EYECARE MIDWEST LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BENNETT EYECARE MIDWEST LLC
Authorized official
DR. ABBIE N RONDEAU OD (CREDENTIALING OFFICER)
(816) 858-2522
Entity
Organization
Contact information
Practice address
6080 N OAK TRFY, SUITE 101, GLADSTONE, MO 64118
(816) 454-2020
(816) 453-2659
Mailing address
2441 NW PRAIRIE VIEW RD, PLATTE CITY, MO 64079-7627
(816) 858-2522
(816) 858-2946
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T02633
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407839756
NPI
MO
01
—
1528041860
NPI
—
01
—
1669455747
NPI
MO
01
—
1811159361
NPI
MO
01
—
2018024194
STATE LICENSE
MO
05
—
312478241
—
MO
05
—
316013606
—
MO
05
—
318693827
—
MO
05
—
505840207
—
MO
05
—
535840201
—
MO
Enumeration date
07/12/2006
Last updated
12/15/2022
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