Organization
EYE MICROSURGERY, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY SHASSERRE (OFFICE MANAGER)
(314) 647-2277
Entity
Organization
Contact information
Practice address
6400 CLAYTON RD, SUITE 416, SAINT LOUIS, MO 63117-1850
(314) 647-2277
Mailing address
6400 CLAYTON RD, SUITE 416, SAINT LOUIS, MO 63117-1850
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
32153
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DG1257
RAILROAD MEDICARE
MO
Enumeration date
03/27/2007
Last updated
11/27/2007
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