Provider Demographics
NPI:1104232073
Name:ABSOLUTE VISION LLC
Entity type:Organization
Organization Name:ABSOLUTE VISION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDOUGALL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:217-222-8800
Mailing Address - Street 1:220 W LOCKWOOD AVE
Mailing Address - Street 2:SUITE 220C
Mailing Address - City:WEBSTER GROVES
Mailing Address - State:MO
Mailing Address - Zip Code:63119-2353
Mailing Address - Country:US
Mailing Address - Phone:314-748-5262
Mailing Address - Fax:314-942-3081
Practice Address - Street 1:220 W LOCKWOOD AVE
Practice Address - Street 2:SUITE 220C
Practice Address - City:WEBSTER GROVES
Practice Address - State:MO
Practice Address - Zip Code:63119-2353
Practice Address - Country:US
Practice Address - Phone:314-748-5262
Practice Address - Fax:314-942-3081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-10
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty