Individual
DR. PAUL D KNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1229 E SEMINOLE ST, 1ST FLOOR, SPRINGFIELD, MO 65804-2227
(471) 820-9393
(417) 820-3758
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T02929
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
108510
MO BLUE SHIELD
MO
05
—
318604006
—
MO
01
—
81596
ARK BLUE SHIELD
AR
Enumeration date
02/06/2007
Last updated
05/13/2013
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