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Organization
PHYSICIANS HEALTH GROUP MEDICAL INC
Active
Organization
PHYSICIANS HEALTH GROUP MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER KAVANAUGH (OWNER)
(636) 305-2000
Entity
Organization
Contact information
Practice address
960 S. HIGHWAY DR, FENTON, MO 63026
(636) 305-2000
(314) 584-7007
Mailing address
P.O. BOX 970, CHESTERFIELD, MO 63006
(636) 305-2000
(314) 584-7007
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
—
MO
208VP0000X
Pain Medicine Physician
Primary
—
MO
Other
Enumeration date
05/22/2014
Last updated
06/01/2015
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