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Organization

FLORISSANT PEDIATRICS INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ELINOR HANCOCK M.D. (PRESIDENT)
(314) 355-6390
Entity
Organization

Contact information

Practice address
4129 N US HIGHWAY 67, FLORISSANT, MO 63034-2825
(314) 355-6390
Mailing address
PO BOX 1209, MARYLAND HEIGHTS, MO 63043-0209

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
R8596
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
202179230
MO
Enumeration date
08/30/2006
Last updated
03/16/2012
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