Organization
ST. ANTHONY'S PHYSICIAN ORGANIZATION
Active
Other names
Mercy Clinic South Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL MATEJKA (CFO EAST COMMUNITIES & SFO)
(314) 251-1958
Entity
Organization
Contact information
Practice address
12152 TESSON FERRY RD, SAINT LOUIS, MO 63128-1726
(314) 849-5414
(314) 849-2042
Mailing address
9735 LANDMARK PARKWAY DR, STE 200, SAINT LOUIS, MO 63127-1646
(314) 543-6985
(314) 543-6836
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000015644
MEDICARE PTAN
MO
Enumeration date
01/15/2016
Last updated
01/04/2019
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