Organization
HANISH EYE INSTITUTE P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SIDNEY J HANISH M.D. (PRESIDENT)
(314) 731-5656
Entity
Organization
Contact information
Practice address
1A VILLAGE SQUARE SHOP CTR, HAZELWOOD, MO 63042-1817
(314) 731-5656
(314) 731-3215
Mailing address
1A VILLAGE SQUARE SHOP CTR, HAZELWOOD, MO 63042-1817
(314) 731-5656
(314) 731-3215
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
R8613
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0800058
UHC
MO
01
—
16711
MOBCBS
MO
Enumeration date
12/17/2007
Last updated
02/12/2008
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