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General NPI Number Information
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NPI Number | 1477694743
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Entity Type | Organization
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Legal Business Name | RETINA GROUP LIMITED PC
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 4550 MEMORIAL DR STE 350
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City | BELLEVILLE
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State | IL
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Zip | 62226-5372
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Country | US
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Telephone | 618-632-8100
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Fax | 618-632-8101
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Provider Business Mailing Address
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Address Line | 4550 MEMORIAL DR STE 350
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City | BELLEVILLE
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State | IL
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Zip | 62226-5372
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Country | US
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Telephone | 618-632-8100
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Fax | 618-632-8101
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ERIC S MANN
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Credential | MD
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Telephone | 618-632-8100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 105431
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 036-094928
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License Number State | IL
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