Individual
RICHARD LYNN NEWCOMB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1411 N JEFFERSON ST, CARROLLTON, MO 64633-1945
(660) 542-2715
(660) 542-2227
Mailing address
1411 N JEFFERSON ST, CARROLLTON, MO 64633-1945
(660) 542-2715
(660) 542-2227
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T02635
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13839018
BLUE CROSS BLUE SHIELD
—
01
—
160226
BLUE CROSS BLUE SHIELD
MO
05
—
312171705
—
MO
01
—
410029304
RAILROAD MEDICARE
—
Enumeration date
08/30/2006
Last updated
06/26/2015
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