KEITH A. MALLATT OD (NPI# 1831379163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1831379163 |
Entity Type | Organization |
Organization Name | KEITH A. MALLATT OD |
Practice Address |
301 N Broadway St Pittsburg KS 66762-4806 |
Practice Telephone | 6202311720 |
Practice Fax Number | 6202311727 |
Mailing Telephone | 6202311720 |
Mailing Fax Number | 6202311727 |
Enumeration Date | 2007-11-03 |
Last Update Date | 2010-04-20 |
Authorized Official Name | DR. KEITH ALLEN MALLATT (OWNER) |
Authorized Official Telephone | 6202311720 |
Authorized Official Credential | O.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | KS 1173-2 | KS | Suppliers |
Street Address |
301 N BROADWAY ST |
City | PITTSBURG |
State | KS |
Zip Code | 66762-4806 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386746857 | Keith Allen Mallatt | Optometrist | 301 N Broadway St, Pittsburg, KS 66762-4806 | 2006-09-03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578172250 | Mallory Kate Revell | Student in an Organized Health Care Education/Training Program | 1701 S Broadway S, Irene Ransom Bradley School of Nursing, Psu, Pittsburg, KS 66762 | 2020-07-28 |
1245849967 | Shelbie Cosby | Student in an Organized Health Care Education/Training Program | 1701 S. Broadway St, Irene Ransom Bradley School of Nursing, Pittsburg, KS 66762 | 2020-07-28 |
1679103642 | Jessica Crager | Nurse Practitioner | 2401 S Tucker Terr, Ste 1, Pittsburg, KS 66762 | 2020-01-18 |
1376198226 | Apollo Services Inc | Durable Medical Equipment & Medical Supplies | 2505 S Springdale, Pittsburg, KS 66762 | 2019-08-07 |
1851885719 | Chelsea Duncan | Social Worker | 911 E Centennial, Pittsburg, KS 66762 | 2018-06-14 |
1902395858 | Alexandria Winter | Specialist/Technologist | 1701 S Homer Street, Pittsburg, KS 66762 | 2018-05-07 |
1811419633 | Troy Richard Quenzer | Specialist/Technologist | 1701 S Homer St, 213 Weede Phys Ed Bldg, Pittsburg, KS 66762 | 2017-07-13 |
1356727002 | John Klodt | Social Worker | 902 E Centennial Dr Apt 13a, Pittsburg, KS 66762 | 2015-08-05 |
1295120533 | Christine E. Conner | Nurse Practitioner | 1 Mt. Carmel Way, 2nd Floor, East, Pittsburg, KS 66762 | 2015-04-03 |
1700278983 | Performance Spine & Sport LLC | Chiropractor | 2597 S. Broadway Suite A, Pittsburg, KS 66762 | 2015-02-25 |
Find all providers in zip 66762 |
Taxonomy Code | 332H00000X |
Grouping | Suppliers |
Classification | Eyewear Supplier (Equipment, not the service) |
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548801335 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 100 Ross Park Mall Dr, Suite A07a, Pittsburg, PA 15237 | 2019-10-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821630187 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 2540 Iowa St Ste K, Lawrence, KS 66046-5754 | 2019-10-08 |
1225595408 | Customeyes LLC | Eyewear Supplier (Equipment, not the service) | 1861 N Rock Rd Ste 214, Wichita, KS 67206-1264 | 2019-02-25 |
1598233652 | Svs Vision Inc | Eyewear Supplier (Equipment, not the service) | 6635 W 135th St, Overland Park, KS 66223-7898 | 2018-11-07 |
1699256271 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 10231 W 21st St N # N107, Wichita, KS 67205-1832 | 2018-08-22 |
1821443250 | Visionworks Inc. | Eyewear Supplier (Equipment, not the service) | 1703 Village West Parkway, Suite 104, Kansas City, KS 66111-0000 | 2016-05-04 |
1982078085 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 15206 W 119th St, Suite A, Olathe, KS 66062-5604 | 2015-11-30 |
1164819843 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 330 Kansas Ave, Bldg. 700, Fort Leavenworth, KS 66027-1139 | 2015-04-21 |
1639437791 | Sunland Optical Co., Inc. | Eyewear Supplier (Equipment, not the service) | 330 Kansas Ave Bldg 700, Fort Leavenworth, KS 66027-1139 | 2012-04-26 |
1437439148 | Eyewear Junction LLC | Eyewear Supplier (Equipment, not the service) | 710 N Washington St, Junction City, KS 66441-2922 | 2011-08-25 |
1659501898 | Meadows-bell Opticians LLC | Eyewear Supplier (Equipment, not the service) | 8838 W 95th St, Overland Park, KS 66212-4051 | 2009-07-22 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.