Organization
SURGERY CENTERS OF MISSOURI, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM DK CRAGG (OWNER/CEO)
(314) 695-8933
Entity
Organization
Contact information
Practice address
12101 WOODCREST EXECUTIVE DR STE 101, CREVE COEUR, MO 63141-5047
(314) 695-8933
Mailing address
1015 S SPOEDE RD, FRONTENAC, MO 63131-2610
(314) 378-2085
(314) 659-8307
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3142232162
PRIVATE INSURANCE
MO
Enumeration date
02/25/2020
Last updated
02/08/2023
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