Individual
DR. ADRIENA COTHRON BEATTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 251-6092
Mailing address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 251-6092
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
036132778
IL
207V00000X
Obstetrics & Gynecology Physician
Primary
2021031102
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036132778
IL LICENSE
IL
01
—
2021031102
MO LICENSE
MO
Enumeration date
05/11/2006
Last updated
12/09/2021
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