Individual
DOUGLAS GERARD HERRIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
221 NW MCNARY CT, LEES SUMMIT, MO 64086-4011
(816) 524-8900
(816) 525-2042
Mailing address
221 NW MCNARY CT, LEES SUMMIT, MO 64086-4011
(816) 524-8900
(816) 525-2042
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1194-2
KS
152W00000X
Optometrist
13504640-9934
UT
152W00000X
Optometrist
1634
NE
152W00000X
Optometrist
3842-35
WI
152W00000X
Optometrist
3889
MN
152W00000X
Optometrist
I5-0000006
DE
152W00000X
Optometrist
Primary
T-02668
MO
152W00000X
Optometrist
TPOP132
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100218090A
—
KS
05
—
100218090B
—
KS
01
—
13233011
BLUE CROSS BLUE SHIELD OF KANSAS CITY
MO
01
—
410020656
RAILROAD MEDICARE
KS
01
—
410038120
MEDICARE RR
MO
01
—
5797074B
MEDICARE ID - UNSPECIFIED
MO
01
—
650867
MEDICARE ID-TYPE UNSPECIFIED
KS
01
—
KA1721001
MEDICARE ID-TYPE UNSPECIFIED
KS
01
—
P00830624
RAILROAD MEDICARE
KS
Enumeration date
07/20/2005
Last updated
02/05/2024
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