Organization
WOODS MILL ANESTHESIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY J COOPER MD (PRESIDENT)
(636) 284-6396
Entity
Organization
Contact information
Practice address
10 HOSPITAL DR, SAINT PETERS, MO 63376-1659
(314) 895-3828
(314) 895-3827
Mailing address
PO BOX 5, HAZELWOOD, MO 63042-0005
(314) 895-3828
(314) 895-3827
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000011761
MEDICARE PTAN
MO
05
—
507732303
—
MO
01
—
CD0710
RAILROAD MEDICARE
—
01
—
CF9682
RAILROAD MEDICARE
—
01
—
CM0398
RAILROAD MEDICARE
—
Enumeration date
01/16/2007
Last updated
01/09/2015
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