Manary, Mark A

Manary, Mark A is an sole proprietor health care provider with primary practice located at 2421 W Edgewood Dr Ste A, Jefferson City MO 65109-5844. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Manary, Mark A can be contacted via phone (573) 636-2103.

Contact Information

Primary practice address
2421 W Edgewood Dr Ste A Jefferson City MO 65109-5844
Phone: (573) 636-2103
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X TO3364 Missouri

Profile Details

NPI number 1972594224
LBN Legal business name Manary, Mark A
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 3rd, 2005
Last updated Jan 30th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972594224 NPPES
Missouri MEDICAID 318903804

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