Organization
CS LARSON OD & ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY W BROWN OD (PRESIDENT)
(573) 774-2040
Entity
Organization
Contact information
Practice address
1390 HIGHWAY F, WAYNESVILLE, MO 65583-0000
(573) 774-2040
(573) 774-6152
Mailing address
1390 HIGHWAY F, WAYNESVILLE, MO 65583-0000
(573) 774-2040
(573) 774-6152
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T03398
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000414171
ANTHEM
—
01
—
0007812292
AETNA
—
01
—
002613709
APWU HEALTH PLAN
—
01
—
1598945859
TRICARE FOR LIFE
—
05
—
1598945859
—
MO
01
—
2195676
MAIL HANDLERS BENEFIT PLAN
—
01
—
2381519
GROUP HEALTH PLAN
—
01
—
650016650016
PREMERA
—
01
—
7102000MO65583
BLUE CROSS AND BLUE SHIELD OF MICHIGAN
—
01
—
916309
ADVANTRA FREEDOM
—
Enumeration date
11/05/2007
Last updated
12/14/2009
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