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Individual

DR. GLEN BRIAN LOJKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
194 CLARKSON RD, ELLISVILLE, MO 63011-2244
(636) 227-2020
(636) 227-9968
Mailing address
PO BOX 207158, DALLAS, TX 75320-7158
(636) 200-4393
(636) 527-0766

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2000170624
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
315949800
MO
01
41047797
RAILROAD MEDICARE
MO
Enumeration date
06/23/2005
Last updated
12/07/2023
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