Organization
SURGICAL ARTS OF ST LOUIS,LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHI KIBLER (ACCOUNT MANAGER)
(314) 770-0991
Entity
Organization
Contact information
Practice address
12266 DEPAUL DR., SUITE 305, BRIDGETON, MO 63044-2516
(314) 770-0192
(314) 700-0692
Mailing address
12266 DEPAUL DR., SUITE 305, BRIDGETON, MO 63044-2516
(314) 770-0991
(314) 770-0692
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200894
ILLINOIS MEDICARE
IL
01
—
200895
ILLINOIS MEDICARE
IL
01
—
CD5646
RAILROAD MEDICARE
MO
Enumeration date
08/13/2006
Last updated
07/21/2022
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