Organization
PAUL SIMON DO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM STELZER (ASSISTANT DIRECTOR OF OPERATIONS)
(636) 939-2550
Entity
Organization
Contact information
Practice address
255 SPENCER RD, SUITE 201, SAINT PETERS, MO 63376-2494
(636) 939-2550
(636) 939-2551
Mailing address
255 SPENCER RD, SUITE 201, SAINT PETERS, MO 63376-2494
(636) 939-2550
(636) 939-2551
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2007003913
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801032925
—
MO
Enumeration date
12/18/2008
Last updated
04/23/2009
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