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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