Organization
STORK OBSTETRICS & GYNECOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK T PATRICK M.D. (PRESIDENT)
(314) 525-4100
Entity
Organization
Contact information
Practice address
10004 KENNERLY RD, SUITE 230A, SAINT LOUIS, MO 63128-2141
(314) 555-4100
(314) 525-4891
Mailing address
PO BOX 771244, SAINT LOUIS, MO 63177-2244
(314) 555-4100
(314) 525-4891
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DG0719
MEDICARE RAILROAD
MO
Enumeration date
08/12/2006
Last updated
01/23/2008
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