institution
Ear Nose & Throat & Plastic Surg Inc
Facial Plastic Surgery Physician in St. Louis, Missouri
NPI 1104911288

Ear Nose & Throat & Plastic Surg Inc is a Facial Plastic Surgery Physician based in St. Louis, MO and is specialized in Facial Plastic Surgery. Ear Nose & Throat & Plastic Surg Inc practices in St. Louis, MO. The NPI Number for Ear Nose & Throat & Plastic Surg Inc is 1104911288 and holds a License No. (Missouri).

The current practice location address for Ear Nose & Throat & Plastic Surg Inc is 2315 Dougherty Ferry Road, St. Louis, MO and can be reached out via phone at 314-821-5002.

Location: 2315 Dougherty Ferry Road, St. Louis, MO, 63122
institution
Provider Profile Details
NPI Number
1104911288
Provider Name
Ear Nose & Throat & Plastic Surg Inc
Credential
Provider Entity Type
Organization
Address
2315 Dougherty Ferry Road, St. Louis, MO, 63122
Phone Number
314-821-5002
Fax Number
Provider Enumeration Date
10/04/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
040010750 01 MO MEDICARE RAILROAD
CP2222 01 MO MEDICARE RAILROAD
040017959 01 MO MEDICARE RAILROAD
040003579 01 MO MEDICARE RAILROAD
502754401 05 MO
institution
Provider Business Practice Location Address Details
Address
2315 Dougherty Ferry Road
City
State
Zip
63122
Phone Number
314-821-5002
Fax Number
person
Provider Business Mailing Address Details
Address
2315 Dougherty Ferry Road
City
State
Zip
63122
Phone Number
314-821-5002
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Otolaryngology
Speciality
Facial Plastic Surgery
Taxonomy
License No.
(Missouri)
Definition
An otolaryngologist who specializes in facial plastic surgery.
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