Organization
OZARK RETINA & MACULA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT EDWIN BENEDETT M.D. (RETINA SPECIALIST)
(417) 830-0889
Entity
Organization
Contact information
Practice address
1230 E KINGSLEY ST STE A, SPRINGFIELD, MO 65804-7231
(417) 830-0889
Mailing address
1230 E KINGSLEY ST STE A, SPRINGFIELD, MO 65804-7231
(417) 830-0889
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MDR3K52
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194724211
INDIVIDUAL NPI
MO
Enumeration date
10/27/2014
Last updated
10/27/2014
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