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Organization
SSM CANCER CARE, INC
Active
Organization
SSM CANCER CARE, INC
Active
Other names
SSM Health Cancer Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ELLIS HAWKINS (PRESIDENT)
(636) 496-2500
Entity
Organization
Contact information
Practice address
400 MEDICAL PLZ, SUITE 100, LAKE SAINT LOUIS, MO 63367-1490
(636) 639-8600
(636) 639-8676
Mailing address
400 MEDICAL PLZ, SUITE 100, LAKE SAINT LOUIS, MO 63367-1490
(636) 639-8600
(636) 639-8676
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
NULL
207RH0003X
Hematology & Oncology Physician
Primary
—
—
2085R0001X
Radiation Oncology Physician
—
NULL
2085R0001X
Radiation Oncology Physician
—
—
Other
Enumeration date
09/29/2010
Last updated
01/25/2016
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