Provider Demographics
NPI:1306847991
Name:PADGET, STEVEN L (OD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:L
Last Name:PADGET
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9507 E 63RD ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RAYTOWN
Mailing Address - State:MO
Mailing Address - Zip Code:64133-4949
Mailing Address - Country:US
Mailing Address - Phone:816-356-5520
Mailing Address - Fax:816-356-2150
Practice Address - Street 1:9507 E 63RD ST
Practice Address - Street 2:SUITE 101
Practice Address - City:RAYTOWN
Practice Address - State:MO
Practice Address - Zip Code:64133-4949
Practice Address - Country:US
Practice Address - Phone:816-356-5520
Practice Address - Fax:816-356-2150
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOT02271152W00000X
KS1071152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO06316019OtherBLUE CROSS BLUE SHIELD
MOT42527Medicare UPIN
MO0000791Medicare ID - Type Unspecified