MEDICARE: SOUTHERN MISSOURI EYE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093518847
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHERN MISSOURI EYE, LLC

Provider Business Mailing Address
First Line	:	1405 DOCTORS DR
Second Line	:
City	:	WEST PLAINS
State	:	MO
Zip	:	65775-4754
Country	:	US
Telephone Number	:	417-256-4111
Fax Number	:	417-256-8939

Provider Business Practice Location Address
First Line	:	1405 DOCTORS DR
Second Line	:
City	:	WEST PLAINS
State	:	MO
Zip	:	65775-4754
Country	:	US
Telephone Number	:	417-256-4111
Fax Number	:	417-256-8939

Authorized Official
Title or Position	:	PRESIDENT AND MEMBER
Name	:	DR. RICHARD EDWARD JONES
Credential	:	MD
Telephone Number	:	417-256-4111

Provider Enumeration Date	:	03/28/2025
Last Update Date	:	04/10/2026

Similar Medicare Providers

1497832083 — DR. LYSA CHARLES MD
Practice Location Address:

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308

1245235456 — DR. RICHARD GRAY TOMPSON M.D.
Practice Location Address:

1410 DOCTORS DR
WEST PLAINS, MO
65775-4754

Practice Phone: 417-256-2225
Practice Fax: 417-256-2373

1073509733 — WEST PLAINS SURGERY CENTER LLC
Practice Location Address:

1401 DOCTORS DR
WEST PLAINS, MO
65775-4754

Practice Phone: 417-256-1400
Practice Fax: 417-256-2885

1821035569 — ROBERT W JONES M.D.
Practice Location Address:

1405 DOCTORS DR
WEST PLAINS, MO
65775-4754

Practice Phone: 417-256-4111
Practice Fax: 417-256-8939

1356351241 — ROBERT W. JONES
Practice Location Address:

1405 DOCTORS DR
WEST PLAINS, MO
65775-4754

Practice Phone: 417-256-4111
Practice Fax: 417-256-8939

1578673414 — PAIN TREATMENT ASSOCIATES LLC
Practice Location Address:

1410 DOCTORS DR
WEST PLAINS, MO
65775-4754

Practice Phone: 417-256-2225
Practice Fax: 417-256-2373

Directions to “SOUTHERN MISSOURI EYE, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.