Organization
KENNETH HALL REGIONAL HOSPITAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL MCMANUS (COO)
(618) 332-5212
Entity
Organization
Contact information
Practice address
129 N 8TH ST, EAST SAINT LOUIS, IL 62201-2917
(618) 482-7044
(618) 482-7018
Mailing address
1836 LACKLAND HILL PKWY, SAINT LOUIS, MO 63146-3572
(314) 872-1439
(314) 810-1399
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
IL
207RP1001X
Pulmonary Disease Physician
—
IL
207Y00000X
Otolaryngology Physician
—
IL
208600000X
Surgery Physician
—
IL
Other
Enumeration date
08/11/2006
Last updated
12/10/2007
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