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Organization

RETINA ASSOCIATES OF ST LOUIS, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SHERRIE KLEEKAMP (OFFICE ADMINISTRATOR)
(314) 839-1211
Entity
Organization

Contact information

Practice address
1224 GRAHAM RD, SUITE 3011, FLORISSANT, MO 63031-8028
(314) 893-1211
(314) 839-8429
Mailing address
1224 GRAHAM RD, SUITE 3011, FLORISSANT, MO 63031-8028
(314) 839-1211
(314) 839-8429

Taxonomy

Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
502634801
MO
01
C17353
RAILROAD MEDICARE
MO
Enumeration date
07/19/2007
Last updated
09/28/2022
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