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:
Health care specialties
| Specialty | Code | License # | 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 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972594224 | NPPES |
| Missouri | MEDICAID | 318903804 |
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