NPI:
1942330477
Provider Name:
MERCY CLINIC KIDS PLASTIC SURGERY, LLC
Former Legal Business Name: KIDS PLASTIC SURGERY, LLC
Classification:
Surgery - 2086S0122X
Entity Type:
Organization
Specialization: Plastic and Reconstructive Surgery
Address:
621 S NEW BALLAS RD
SUITE 260-A
SAINT LOUIS, MO
ZIP 63141
Phone:
(314) 251-4772
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MERCY CLINIC KIDS PLASTIC SURGERY, LLC is a plastic and reconstructive surgery surgery in Saint Louis, MO. The provider is a surgeon who specializes in plastic and reconstructive surgery. MERCY CLINIC KIDS PLASTIC SURGERY, LLC NPI is 1942330477. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Kids Plastic Surgery, Llc.
The provider's business location address is:
621 S NEW BALLAS RD
SUITE 260-A
SAINT LOUIS, MO
ZIP 63141-232
Phone: (314) 251-4772
Fax: (314) 251-5772
The provider's authorized official is John W. Hubert .
The authorized official title is President and has the following contact phone number (314) 251-1700.
The enumeration date for this NPI number is 3/6/2007 and was last updated on 5/2/2014.