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General NPI Number Information
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NPI Number | 1730207994
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Entity Type | Organization
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Legal Business Name | EYE MICROSURGERY, LTD.
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 11/27/2007
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Provider Practice Location Address
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Address Line | 6400 CLAYTON RD SUITE 416
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City | SAINT LOUIS
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State | MO
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Zip | 63117-1850
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Country | US
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Telephone | 314-647-2277
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Fax |
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Provider Business Mailing Address
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Address Line | 6400 CLAYTON RD SUITE 416
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City | SAINT LOUIS
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State | MO
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Zip | 63117-1850
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | KATHY SHASSERRE
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Credential |
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Telephone | 314-647-2277
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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 | 32153
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License Number State | MO
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