Organization
STATE LINE EYE CARE CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILLIAM (LILY) S YOHN (SECRETARY/OFFICE MANAGER)
(816) 444-2900
Entity
Organization
Contact information
Practice address
7701 STATE LINE RD, KANSAS CITY, MO 64114-1635
(816) 444-2900
(816) 444-3304
Mailing address
7701 STATE LINE RD, KANSAS CITY, MO 64114-1635
(816) 444-2900
(816) 444-3304
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19517011
BLUE CROSS BLUE SHIELD
MO
05
—
509417606
—
MO
Enumeration date
06/09/2006
Last updated
03/03/2015
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