Individual
DR. JAROD LANCE MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2002014341
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061 1012754
EYEMED VISION CARE
MO
01
—
16528
SPECTERA
MA
01
—
1684191
HIGHMARK BLUE SHIELD
PA
01
—
189230
ANTHEM BCBS
MO
01
—
197614
GREAT-WEST HEALTHCARE
MO
01
—
262102
NVA
NJ
05
—
319118907
—
MO
01
—
32-0123262
VBA
PA
01
—
320123262
VISION SERVICE PLAN
CA
01
—
320123262
CONSTRUCTION LABORERS
MO
01
—
36609
BOILERMAKERS NATIONAL H&W
KS
01
—
44844
DAVIS VISION
NY
01
—
49877
HEALTHCARE USA
MO
01
—
509638
EPOCH
MO
01
—
648
SVS VISION
MI
01
—
7942654
AETNA
KY
01
—
892837
MERCY CARE PLUS
MO
Enumeration date
03/13/2007
Last updated
01/30/2014
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