Individual
DR. JAROD LANCE MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
202 WALNUT ST, FESTUS, MO 63028-1850
(636) 937-3130
(636) 937-7202
Mailing address
202 WALNUT ST, FESTUS, MO 63028-1850
(636) 937-3130
(636) 937-7202
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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