Organization
PAUL A. MOCCIA, O.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL A. MOCCIA O.D. (PRESIDENT)
(913) 367-9270
Entity
Organization
Contact information
Practice address
1103 S 4TH ST, ATCHISON, KS 66002-3109
(913) 367-9270
Mailing address
1103 S 4TH ST, ATCHISON, KS 66002-3109
(913) 367-9270
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1286-3
KS
332B00000X
Durable Medical Equipment & Medical Supplies
1286-3
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100218590B
—
KS
01
—
1286-3
STATE LICENSE
KS
05
—
312562341
—
MO
01
—
TO2769
STATE LICENSE
MO
Enumeration date
02/08/2008
Last updated
09/30/2010
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