Individual
DR. THOMAS KELLY MANGELSDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
18 UPPER LADUE, ST LOUIS, MO 63124-1675
(314) 997-5440
Mailing address
18 UPPER LADUE, ST LOUIS, MO 63124-1675
(314) 997-5440
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
26419
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201385317
—
MO
Enumeration date
01/26/2009
Last updated
03/07/2023
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