Organization
PEDIATRIX MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY A BRENNER MD (DIRECTOR)
(314) 251-5860
Entity
Organization
Contact information
Practice address
621 S NEW BALLAS RD, SUITE 2016B, SAINT LOUIS, MO 63141-8232
(314) 251-5860
(314) 251-5861
Mailing address
621 S NEW BALLAS RD, SUITE 2016B, SAINT LOUIS, MO 63141-8232
(314) 251-5860
(314) 251-5861
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
2000169319
MO
Other
Enumeration date
07/02/2006
Last updated
08/22/2020
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