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General NPI Number Information
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NPI Number | 1447472600
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Entity Type | Organization
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Legal Business Name | EYE SURGEONS OF SPRINGFIELD, INC.
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 10/23/2023
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Provider Practice Location Address
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Address Line | 1330 E KINGSLEY ST
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City | SPRINGFIELD
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State | MO
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Zip | 65804-7216
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Country | US
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Telephone | 417-887-1965
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Fax | 417-887-6499
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Provider Business Mailing Address
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Address Line | 1330 E KINGSLEY ST
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City | SPRINGFIELD
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State | MO
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Zip | 65804-7216
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Country | US
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Telephone | 417-887-1965
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Fax | 417-887-6499
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MRS. SUSAN R SALES
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Credential |
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Telephone | 417-887-1965
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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