Retina & Vitreous Consultants INC

NPI #1255452603 in Saint Louis, Missouri

Provider Information

NPI Number: 1255452603
Entity Type: Organization
Organization Name: Retina & Vitreous Consultants INC
Primary Specialty: Ophthalmology
Enumeration Date: Apr 3, 2007
Last Updated: Mar 13, 2012

Practice Location

Address: 1034 S BRENTWOOD BLVD
Address 2: SUITE 1625
City: Saint Louis
State: Missouri
ZIP Code: 63117-1223
Phone: (314) 881-1211

Authorized Official

Name: MRS. STACY L DEISS
Title: CREDENTIALING MANAGER
Phone: (314) 367-1278

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Ophthalmology	207W00000X	Primary

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