OTIS OPTOMETRY LLC NPI 1568873602

NPI Information

  • NPI: 1568873602
  • Provider Name: OTIS OPTOMETRY, LLC
  • Classification: Optometrist - 152W00000X
  • Entity Type: Organization
  • Address: 94 CECIL ST
    CAMDENTON, MO
    ZIP 65020
  • Phone: (573) 317-9279

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NPI Details

OTIS OPTOMETRY, LLC is an optometrist in Camdenton, MO. The provider is doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. OTIS OPTOMETRY, LLC NPI is 1568873602. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

94 CECIL ST
CAMDENTON, MO
ZIP 65020-057
Phone: (573) 317-9279
Fax: (888) 841-1312

The provider's authorized official is Matt David Wickham .
The authorized official title is Owner and has the following contact phone number (314) 276-1228.

The enumeration date for this NPI number is 5/12/2014 and was last updated on 7/29/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1152W00000XOptometristTO3134MISSOURIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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