| NPI | 1144204553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY R BLAIR President 573-874-1616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: MO MD108058) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2020-12-03 |