Organization
PARKWAY ORTHOPAEDIC GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYU SOP CHO MD (PRESIDENT)
(314) 569-1830
Entity
Organization
Contact information
Practice address
11330 S 40 DR, SAINT LOUIS, MO 63131-2555
(314) 569-1830
(314) 983-9922
Mailing address
11330 S 40 DR, SAINT LOUIS, MO 63131-2555
(314) 569-1830
(314) 983-9922
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
33982
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100215
HEALTHLINK
—
01
—
21203
BLUE CROSS BLUE SHIELD
—
01
—
4057743
AETNA
—
05
—
5830160033
—
IL
01
—
P00230577
RR MEDICARE
—
Enumeration date
08/20/2007
Last updated
04/20/2008
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