# MERCY CLINIC CHILDREN'S UROLOGY LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MERCY MEDICAL GROUP
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1154612166
- **Legal business name:** MERCY MEDICAL GROUP
- **Authorized official:** KERRY DUNGER (EXECUTIVE DIRECTOR - FINANCE)
- **Authorized official phone:** (314) 364-3707

## Contact information

- **Practice address:** 621 S NEW BALLAS RD, SUITE 537-A, SAINT LOUIS, MO 63141-8232
- **Practice address phone:** (314) 251-6990
- **Practice address fax:** (314) 251-6998
- **Mailing address:** 621 S NEW BALLAS RD, SUITE 537-A, SAINT LOUIS, MO 63141-8232
- **Mailing address phone:** (314) 251-6990
- **Mailing address fax:** (314) 251-6998

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2088P0231X | Pediatric Urology Physician | — | NULL | Yes |
| 2088P0231X | Pediatric Urology Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/25/2011
- **Last updated:** 04/28/2025