NPI 1700832367

Mid-County Urology INC

Organisation Urology Physician Saint Louis, MO

Practice location

Address: 621 S New Ballas Rd Suite 6011b, Saint Louis, MO 63141-8232
Phone: (314) 569-1750
Fax: (314) 569-3846

Authorised official

Name: Leonard D Gaum
Title: Owner President
Phone: (314) 569-1750

Registered specialties (2)

Urology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208800000X Licence R4A96 (MO)

Other Urology providers in Missouri →

Urology Physician

Allopathic & Osteopathic Physicians Taxonomy 208800000X Licence 103702 (MO)

Registry record

NPI: 1700832367
Entity type: Organization
NPI issued: 25 May 2006
Record last updated: 2 Oct 2012

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.