Individual
DR. MARSHALL VERNON MUNCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
175 SHINN LN, HANNIBAL, MO 63401
(573) 248-0008
Mailing address
1025 MAINE ST, QUINCY, IL 62301-4038
(217) 222-6550
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T03361
MO
152WC0802X
Corneal and Contact Management Optometrist
TO3361
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1245285543
MEDICARE GROUP NPI
MO
01
—
134570018
MEDICARE PTAN FOR QMG
MO
05
—
318910718
—
MO
01
—
410045181
RAILROAD MEDICARE
MO
01
—
990000642
MEDICARE GROUP
MO
01
—
CI3223
RAILROAD MEDICARE GROUP
MO
Enumeration date
06/05/2006
Last updated
05/18/2018
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