Individual
DR. THOMAS JONATHAN FOUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 CHILDRENS PL, DIV NEUROLOGY PEDIATRICS, SAINT LOUIS, MO 63110-1002
(314) 362-1408
(314) 454-2523
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 362-1408
(314) 454-2523
Taxonomy
Speciality
Code
Description
License number
State
2084E0001X
Epilepsy Physician
Primary
2019026355
MO
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
2019026355
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200073674
—
MO
Enumeration date
03/21/2013
Last updated
04/17/2025
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