Basic Information
| Provider Information | |||||||||
| NPI: | 1770061210 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | METHVIN | ||||||||
| FirstName: | SETH | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | OD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4027 MILL ST | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641113008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8165611665 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10127 STATE LINE RD | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641144262 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8167652500 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/06/2018 | ||||||||
| LastUpdateDate: | 08/06/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 2018027923 | MO | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.