Individual
DR. JUSTIN M SACKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4921 PARKVIEW PL, DIV SURG PLASTICS, STE 6G, SAINT LOUIS, MO 63110-1032
(314) 362-7388
(833) 301-0853
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 362-7388
(833) 301-0853
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
2020005824
MO
2086S0122X
Plastic and Reconstructive Surgery Physician
2020005824
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200080860
—
MO
Enumeration date
10/17/2006
Last updated
04/17/2025
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