Organization
JEFFERSON PHYSICIAN NETWORK, LLC
Active
Organization
JEFFERSON PHYSICIAN NETWORK, LLC
Active
Parent organization
JEFFERSON MEMORIAL HOSPITAL ASSOCIATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
JEFFERSON MEMORIAL HOSPITAL ASSOCIATION
Authorized official
MR. DANIEL S. ECKENFELS (CFO)
(636) 933-1107
Entity
Organization
Contact information
Practice address
1400 HIGHWAY 61, SUITE 240, FESTUS, MO 63028-4100
(636) 931-4002
Mailing address
1400 US HIGHWAY 61, FESTUS, MO 63028-4100
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
2007029096
MO
Other
Enumeration date
01/12/2009
Last updated
03/12/2013
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