# FAMILY MEDICINE - SLMG SOUTH, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ST. LUKES MEDICAL GROUP
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1164077822
- **Legal business name:** ST. LUKES MEDICAL GROUP
- **Authorized official:** DARREN R. HASKELL M.D. (CHIEF MEDICAL OFFICER)
- **Authorized official phone:** (314) 205-6444

## Contact information

- **Practice address:** 1501 PROFESSIONAL DR, IMPERIAL, MO 63052-3809
- **Practice address phone:** (636) 464-4000
- **Practice address fax:** (636) 529-0699
- **Mailing address:** 121 SAINT LUKES CENTER DR, CHESTERFIELD, MO 63017-3518
- **Mailing address phone:** (636) 685-7804

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/08/2019
- **Last updated:** 03/05/2026