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Organization

ST. ANTHONY'S PHYSICIAN ORGANIZATION

Active
Other names
Mercy Clinic South Physicians
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CHERYL MATEJKA (CFO EAST COMMUNITIES & SFO)
(314) 251-1958
Entity
Organization

Contact information

Practice address
10004 KENNERLY RD, SUITE 205A, SAINT LOUIS, MO 63128-2141
(314) 525-4327
(314) 525-4368
Mailing address
10004 KENNERLY RD, SUITE 205A, SAINT LOUIS, MO 63128-2141
(314) 525-4327
(314) 525-4368

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000015644
MEDICARE PTAN
MO
Enumeration date
01/17/2014
Last updated
01/04/2019
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