Individual
DR. KELLY D GAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3844 S LINDBERGH BLVD., SUITE 160, ST. LOUIS, MO 63127
(314) 698-2500
(314) 698-2323
Mailing address
3844 S LINDBERGH BLVD., SUITE 160, ST. LOUIS, MO 63127
(314) 698-2500
(314) 698-2323
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R6J64
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01134613
RAILROAD MEDICARE
MO
Enumeration date
05/18/2006
Last updated
04/18/2014
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