Individual
DR. JEFFREY ROBERT PADOUSIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
522 N NEW BALLAS RD, STE 136, SAINT LOUIS, MO 63141-6857
(314) 432-7010
(314) 872-7141
Mailing address
522 N NEW BALLAS ROAD, STE 136, SAINT LOUIS, MO 63141
(314) 432-7010
(314) 872-7141
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
2004009707
MO
Other
Enumeration date
10/19/2006
Last updated
10/09/2019
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