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Pg Optical LLC

NPI 1447950183ActiveOrganization· Optometrist· Rolla, MO

Optometrist in Rolla, Missouri, registered in NPPES in March 2023. The authorized official on file is Kevin Gardner, OD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.

Overview

NPI1447950183
StatusActive
Entity typeOrganization
NPI issuedMar 9, 2023
Last updated in NPPESNov 20, 2023
Certified by providerNov 20, 2023

Specialties and licenses

TaxonomyCodeLicenseState
Optometrist Primary152W00000X——

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026No match—
New York OMIG · Nov 10, 2026No match—
Ohio Medicaid · Nov 10, 2026No match—
Pennsylvania Medicheck · Nov 10, 2026No match—
Washington HCA · Nov 10, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Enrolled Part B Supplier - Clinic/Group Practice (MO)

Medicare sources and data years

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