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Individual

BRIAN PATRICK SUMNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD.

Contact information

Practice address
320 WASHINGTON AVE, WASHINGTON, MO 63090-3218
(636) 239-2179
(636) 239-9592
Mailing address
320 WASHINGTON AVE, WASHINGTON, MO 63090-3218
(636) 239-2179
(636) 239-9592

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TO2351
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
122489
HEALTHLINK
MO
01
2202100
UNITED HEALTH CARE
MO
01
233006
GROUP HEALTH PLAN
MO
05
310206214
MO
01
32218
BLUE CROSS BLUE SHIELD
MO
Enumeration date
05/31/2005
Last updated
06/08/2020
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