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Individual

DR. IAN K HORNSTRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
915 N GRAND BLVD, SAINT LOUIS, MO 63106
(314) 652-4100
(314) 238-6569
Mailing address
9858 WARSON POINTE DR, SAINT LOUIS, MO 63119-1056
(314) 239-2039

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
R2H85
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
208235903
MO
Enumeration date
07/14/2006
Last updated
05/07/2024
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