Organization
SSM CANCER CARE, INC
Active
Other names
SSM Health Cancer Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ELLIS HAWKINS (PRESIDENT)
(636) 496-2500
Entity
Organization
Contact information
Practice address
400 MEDICAL PLZ, SUITE 100, LAKE SAINT LOUIS, MO 63367-1490
(636) 639-8600
(636) 639-8676
Mailing address
400 MEDICAL PLZ, SUITE 100, LAKE SAINT LOUIS, MO 63367-1490
(636) 639-8600
(636) 639-8676
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
2085R0001X
Radiation Oncology Physician
—
—
Other
Enumeration date
09/29/2010
Last updated
01/25/2016
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