| |
7331 Watson Rd, Saint Louis, MO 63119-4405 | |
(314) 752-7100 | |
(314) 752-3256 |
Full Name | |
---|---|
Type | Facility |
Speciality | Specialist |
Location | 7331 Watson Rd, Saint Louis, Missouri |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1922266212 | NPI | - | NPPES |
502461700 | Medicaid | MO | |
CH3968 | Other | MO | RR MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (Missouri) | Secondary |
174400000X | Specialist | (Missouri) | Primary |
Mailing Address | Practice Location Address |
---|---|
7345 Watson Rd, Saint Louis, MO 63119-4405 Ph: (314) 752-7100 | 7331 Watson Rd, Saint Louis, MO 63119-4405 Ph: (314) 752-7100 |