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Organization
RETINA ASSOCIATES OF ST LOUIS, INC
Active
Organization
RETINA ASSOCIATES OF ST LOUIS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHERRIE KLEEKAMP (OFFICE ADMINISTRATOR)
(314) 839-1211
Entity
Organization
Contact information
Practice address
1224 GRAHAM RD, SUITE 3011, FLORISSANT, MO 63031-8028
(314) 893-1211
(314) 839-8429
Mailing address
1224 GRAHAM RD, SUITE 3011, FLORISSANT, MO 63031-8028
(314) 839-1211
(314) 839-8429
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
502634801
—
MO
01
—
C17353
RAILROAD MEDICARE
MO
Enumeration date
07/19/2007
Last updated
09/28/2022
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