Jeff Birdsong, O.D.
Optometrist in Boonville, MO. Individual provider (NPI-1).
NPI number1790777191
StatusActive
Last updated in NPPESSep 9, 2008
Details
- NPI
- 1790777191
- Entity type
- Individual (NPI-1)
- Name
- Jeff Birdsong
- Credential
- O.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 22, 2005
- Last updated
- Sep 9, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 2004017361 | MO | Yes |
Practice location
505 E Walnut StBoonville, MO 65233-1665
Phone 660-882-2444 · Fax 660-882-7976
Mailing address
505 E Walnut StBoonville, MO 65233-1665
Phone 660-882-2444 · Fax 660-882-7976
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