Individual
ROBYN LEITH HAITHCOCK SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
100 VILLAGE SQ, HAZELWOOD, MO 63042-1820
(314) 355-4010
(314) 355-9484
Mailing address
PO BOX 23340, SAINT LOUIS, MO 63156-3340
(314) 851-1000
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
105736
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
246971709
—
MO
Enumeration date
06/21/2005
Last updated
10/11/2023
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