Organization
MIDWEST NEUROSURGEONS, LLC
Active
Parent organization
MIDWEST NEUROSURGEONS LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MIDWEST NEUROSURGEONS LLC
Authorized official
SONJAY JOSEPH FONN DO (OWNER)
(314) 408-0129
Entity
Organization
Contact information
Practice address
2901 UNION RD STE 100, SAINT LOUIS, MO 63125-3972
(314) 408-0129
(314) 408-0141
Mailing address
PO BOX 614, CAPE GIRARDEAU, MO 63702-0614
(573) 651-1687
(573) 651-8734
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
261QP3300X
Pain Clinic/Center
—
—
Other
Enumeration date
07/10/2013
Last updated
10/26/2024
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