Organization
RETINA CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY ANN THOMPSON (ADMINISTRATOR)
(314) 569-2020
Entity
Organization
Contact information
Practice address
11710 OLD BALLAS RD, SUITE 102, SAINT LOUIS, MO 63141-7076
(314) 569-2020
(314) 569-1596
Mailing address
11710 OLD BALLAS RD, SUITE 102, SAINT LOUIS, MO 63141-7076
(314) 569-2020
(314) 569-1596
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
2004012770
MO
207W00000X
Ophthalmology Physician
Primary
R9531
MO
207WX0107X
Retina Specialist (Ophthalmology) Physician
—
—
Other
Enumeration date
01/31/2007
Last updated
01/24/2024
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