# KENNETH HALL REGIONAL HOSPITAL, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568473510
- **Authorized official:** MR. MICHAEL MCMANUS (COO)
- **Authorized official phone:** (618) 332-5212

## Contact information

- **Practice address:** 129 N 8TH ST, EAST SAINT LOUIS, IL 62201-2917
- **Practice address phone:** (618) 482-7044
- **Practice address fax:** (618) 482-7018
- **Mailing address:** 1836 LACKLAND HILL PKWY, SAINT LOUIS, MO 63146-3572
- **Mailing address phone:** (314) 872-1439
- **Mailing address fax:** (314) 810-1399

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | IL | Yes |
| 207RP1001X | Pulmonary Disease Physician | — | IL | — |
| 207Y00000X | Otolaryngology Physician | — | IL | — |
| 208600000X | Surgery Physician | — | IL | — |

## Other

- **Enumeration date:** 08/11/2006
- **Last updated:** 12/10/2007