Organization
ADVANTAGE PULMONARY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL REAGAN (OFFICE MANAGER)
(314) 878-4699
Entity
Organization
Contact information
Practice address
969 N MASON RD, SUITE 250, SAINT LOUIS, MO 63141-6338
(314) 878-4699
(314) 878-3558
Mailing address
969 N MASON RD, SUITE 250, SAINT LOUIS, MO 63141-6338
(314) 878-4699
(314) 878-3558
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201566726
—
MO
05
—
508115003
—
MO
Enumeration date
12/12/2006
Last updated
03/25/2011
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