Provider Demographics
NPI:1447506381
Name:STRAND, MORGAN ALLYCE (OD)
Entity type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:ALLYCE
Last Name:STRAND
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:MROGAN
Other - Middle Name:ALLYCE
Other - Last Name:BERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:3019 WILLIAM ST STE 102
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63703-6385
Mailing Address - Country:US
Mailing Address - Phone:573-339-2020
Mailing Address - Fax:
Practice Address - Street 1:3019 WILLIAM ST STE 102
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-6385
Practice Address - Country:US
Practice Address - Phone:573-339-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046.010602152W00000X
MO2012025572152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1705003Medicare PIN