Provider Demographics
NPI:1679541452
Name:PICKER, DAVID M (OD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:PICKER
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:10867 W FLORISSANT AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-2405
Mailing Address - Country:US
Mailing Address - Phone:314-817-5367
Mailing Address - Fax:314-522-1027
Practice Address - Street 1:3718 S KINGSHIGHWAY BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63109-1800
Practice Address - Country:US
Practice Address - Phone:314-446-1134
Practice Address - Fax:314-446-1136
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2023-11-29
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Provider Licenses
StateLicense IDTaxonomies
MOTO2576152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO318498318Medicaid
2230948OtherUNITED HEALTHCARE
MO56418OtherHEALTHCARE USA
188384OtherHEALTHLINK
5311OtherMERCY HEALTH PLAN
MO2576OtherEYEMED
197948OtherBLUE CROSS BLUE SHIELD MO
MO2576OtherEYEMED
??T92153Medicare UPIN