Organization
ST LOUIS UNIVERSITY
Active
Organization
ST LOUIS UNIVERSITY
Active
Other names
SLUCare Department of Pediatric Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALYCE LANXON (EXECUTIVE DIRECTOR)
(314) 977-6828
Entity
Organization
Contact information
Practice address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 977-6828
Mailing address
1831 CHESTNUT ST STE 650, SAINT LOUIS, MO 63103-2236
(314) 977-6828
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
—
—
Other
Enumeration date
02/08/2006
Last updated
06/21/2019
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