Organization
THE RETINA INSTITUTE LLC
Active
Other names
BARNES RETINA INSTITUTE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. M GILBERT GRAND M.D. (MANAGER)
(314) 367-1181
Entity
Organization
Contact information
Practice address
4921 PARKVIEW PL, STE 12B, SAINT LOUIS, MO 63110-1032
(314) 367-1181
(314) 968-5117
Mailing address
1600 S BRENTWOOD BLVD, STE 800, SAINT LOUIS, MO 63144-1317
(314) 367-1181
(314) 968-5117
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
N/A
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04121950
BCBS
IL
05
—
502111305
—
MO
01
—
541
BCBS
MO
Enumeration date
06/01/2005
Last updated
01/23/2009
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