Organization
ENT ASSOCIATES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MARIE LAWRENCE (ADMINISTRATOR)
(314) 523-5303
Entity
Organization
Contact information
Practice address
226 S WOODS MILL RD, SUITE 37W, CHESTERFIELD, MO 63017-3662
(314) 523-5303
(314) 523-5703
Mailing address
226 S WOODS MILL RD, SUITE 37W, CHESTERFIELD, MO 63017-3662
(314) 523-5303
(314) 523-5703
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
—
—
207YS0123X
Facial Plastic Surgery Physician
—
—
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CT0559
RAILROAD MEDICARE
MO
Enumeration date
09/29/2006
Last updated
01/13/2009
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