Individual
LASHELL KAY LABOUNTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
3635 VISTA AVE, SAINT LOUIS, MO 63110-2539
(314) 577-8777
Mailing address
3635 VISTA AVE, SAINT LOUIS, MO 63110-2539
(314) 577-8780
(314) 577-8516
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2019010645
MO
207Q00000X
Family Medicine Physician
036.138086
IL
207Q00000X
Family Medicine Physician
Q0295
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036.138086
LICENSE NUMBER
IL
01
—
2019010645
LICENSE
MO
01
—
Q0295
LICENSE
TX
Enumeration date
06/29/2012
Last updated
07/31/2019
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