Healthcare Provider Details

I. General information

NPI: 1144277252
Provider Name (Legal Business Name): MISSOURI EYE INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 03/19/2024
Certification Date: 03/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1531 E BRADFORD PKWY SUITE 100
SPRINGFIELD MO
65804-6566
US

IV. Provider business mailing address

1531 E BRADFORD PKWY SUITE 100
SPRINGFIELD MO
65804-6566
US

V. Phone/Fax

Practice location:
  • Phone: 417-887-3900
  • Fax: 417-887-3221
Mailing address:
  • Phone: 417-887-3900
  • Fax: 417-887-3221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. FRANCIS CHARLES JANSEN
Title or Position: MEMBER
Credential: M.D.
Phone: 417-887-3900