NPI 1114990454

St Louis University

Organisation Pediatric Surgery Physician Saint Louis, MO

Practice location

Address: 1465 S Grand Blvd, Saint Louis, MO 63104-1003
Phone: (314) 977-6828
Mailing address: 1831 Chestnut St STE 650, Saint Louis, MO 63103-2236

Authorised official

Name: Alyce Lanxon
Title: Executive Director
Phone: (314) 977-6828

Registered specialties

Pediatric Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2086S0120X

Other Surgery providers in Missouri →

Registry record

NPI: 1114990454
Entity type: Organization
NPI issued: 8 Feb 2006
Record last updated: 21 Jun 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.