# PARKWAY PATHOLOGY GROUP

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PARKWAY PATHOLOGY GROUP
- **Other names:** Parkway Pathology MO Bap Sullivan
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1750580510
- **Legal business name:** PARKWAY PATHOLOGY GROUP
- **Authorized official:** CHARLES SHORT MD (PRESIDENT)
- **Authorized official phone:** (314) 996-4285

## Contact information

- **Practice address:** 751 SAPPINGTON BRIDGE RD, ATTN: PATHOLOGY DEPARTMENT, SULLIVAN, MO 63080-2354
- **Practice address phone:** (573) 468-4186
- **Mailing address:** PO BOX 500720, SAINT LOUIS, MO 63150-0720
- **Mailing address phone:** (314) 989-0300

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZC0500X | Cytopathology Physician | — | NULL | — |
| 207ZC0500X | Cytopathology Physician | — | — | — |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | NULL | Yes |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/12/2007
- **Last updated:** 10/22/2007