Individual
DR. ELLIOT LAWRENCE KORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1715 DEER TRACKS TRL STE 130, SAINT LOUIS, MO 63131-1854
(314) 567-1856
(314) 527-2425
Mailing address
1715 DEER TRACKS TRL STE 130, SAINT LOUIS, MO 63131-1854
(314) 567-1856
(314) 527-2425
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
R6E34
MO
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
R6E34
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202318507
—
MO
01
—
R51061708
BLUE CROSS BLUE SHIELD
MO
Enumeration date
09/29/2005
Last updated
03/14/2022
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