Individual
DR. MICHAEL J. KATICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4305 BUTLER HILL RD, SAINT LOUIS, MO 63128-3718
(314) 487-4744
Mailing address
PO BOX 207158, DALLAS, TX 75320-7158
(636) 200-4393
(636) 527-0766
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TO2861
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000091336
MEDICARE PART B PTAN
MO
01
—
100684
BLUE CROSS BLUE SHIELD MO
—
01
—
110969
EYEMED
—
01
—
12062
OPTICAREMEDICARE COMPLETE
—
01
—
179835
HEALTHLINK
—
01
—
22-01200
UNITED HEALTHCARE
—
05
—
313428427
—
MO
01
—
410048086
RR MEDICARE
IL
01
—
4185
HEALTHCARE USA
MO
01
—
P00403019
RR MEDICARE
MO
Enumeration date
03/07/2006
Last updated
08/17/2022
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