Individual
SUZANNE M. PAUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1445 CHRISTY DR, JEFFERSON CITY, MO 65101-2853
(573) 636-3483
(573) 636-5315
Mailing address
525 COUCH AVE, KIRKWOOD, MO 63122-5536
(573) 636-3483
(573) 636-5315
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
R1K42
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203681523
—
MO
01
—
P00387102
RR MEDICARE
MO
Enumeration date
09/20/2005
Last updated
05/21/2008
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