Parkside Surgery And Medicine
Surgery in Saint Louis, MO. Organization (NPI-2).
NPI number1497944094
StatusActive
Last updated in NPPESOct 18, 2007
Details
- NPI
- 1497944094
- Entity type
- Organization (NPI-2)
- Legal business name
- Parkside Surgery And Medicine
- Organization subpart
- No
- Enumeration date
- Oct 18, 2007
- Last updated
- Oct 18, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208600000X | Surgery | R5845 | MO | Yes |
Practice location
6125 Clayton AveSuite 430
Saint Louis, MO 63139-3265
Phone 314-768-3634 · Fax 314-768-3638
Mailing address
6125 Clayton AveSuite 430
Saint Louis, MO 63139-3265
Phone 314-768-3634 · Fax 314-768-3638
Authorized official
Julian C Mosley
General Surgeon/Owner
3147683634
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