Organization
SAINT LOUIS UNIVERSITY HOSPITAL- DEPT OF NEUROSURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALYCE LANXON (EXECUTIVE DIRECTOR)
(314) 977-6828
Entity
Organization
Contact information
Practice address
3655 VISTA AVE, SAINT LOUIS, MO 63110-2539
(314) 977-4440
Mailing address
3545 LINDELL BLVD FL 3, SAINT LOUIS, MO 63103-1020
(314) 577-8849
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
2010003185
MO
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2010003185
MISSOURI MEDICAL LICENSE
MO
Enumeration date
04/27/2010
Last updated
09/21/2021
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