Organization
EAR NOSE THROAT MEDICAL SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN BURK (DESIGNATED OFFICIAL)
(314) 541-6838
Entity
Organization
Contact information
Practice address
226 S WOODS MILL RD STE 44W, CHESTERFIELD, MO 63017-3442
(314) 447-4995
(314) 682-6093
Mailing address
1324 CLARKSON CLAYTON CTR STE 301, ELLISVILLE, MO 63011-2145
(314) 541-6838
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
11/05/2019
Last updated
10/03/2022
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