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Organization

STL PLASTIC AND HAND SURGERY, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROBERT HAGAN MD (MANAGING EMPLOYEE/OWNER)
(314) 434-7784
Entity
Organization

Contact information

Practice address
12855 N 40 DR, NORTH TOWER SUITE 380, SAINT LOUIS, MO 63141-8657
(314) 434-7784
Mailing address
12855 N 40 DR, NORTH TOWER SUITE 380, SAINT LOUIS, MO 63141-8657
(314) 434-3603
(314) 434-3603

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
2002014802
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DF1612
RR MEDICARE
MO
Enumeration date
07/16/2006
Last updated
08/12/2014
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