Organization
HODAG MEDICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL E. BURK DO (PHYSICIAN)
(314) 821-5002
Entity
Organization
Contact information
Practice address
4800 MEXICO RD STE 103, SAINT PETERS, MO 63376-1666
(636) 936-5002
(314) 821-5029
Mailing address
1324 CLARKSON CLAYTON CTR UNIT 301, ELLISVILLE, MO 63011-2145
(314) 541-6838
Taxonomy
Speciality
Code
Description
License number
State
207YX0602X
Otolaryngic Allergy Physician
R6G71
MO
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
R6G71
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1790786838
NPI
—
05
—
242428308
—
MO
Enumeration date
06/22/2017
Last updated
08/13/2019
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