Individual
MR. JOSEPH ANTHONY KISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA-C
Contact information
Practice address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 251-6000
(636) 386-7679
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
2014032277
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386046878
—
MO
Enumeration date
09/16/2014
Last updated
09/12/2019
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