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Organization

PAIGE HEDGPATH ODPC

Active
Other names
Eyes On Missouri
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ELIZABETH PAIGE HEDGPATH (PRESIDENT)
(573) 635-1313
Entity
Organization

Contact information

Practice address
1400 FORUM BLVD, COLUMBIA, MO 65203-1997
(573) 446-0331
(800) 432-6004
Mailing address
211 E BROADWAY, ALTON, IL 62002-6220
(618) 462-9818
(800) 432-6004

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1013072966
MEDICARE
MO
01
14070
SPECTERA
MO
01
1669441630
MEDICARE
MO
01
1669530887
MEDICARE
MO
01
1962644732
MEDICARE
MO
01
MA1757
MEDICARE
MO
01
MA1757001
MEDICARE
MO
01
MA1757002
MEDICARE
MO
Enumeration date
12/04/2006
Last updated
04/21/2017
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