Individual
GILBERT L PHON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AU.D., FAAA
Contact information
Practice address
4200 N CLOVERLEAF DR, SUITE B, SAINT PETERS, MO 63376-6436
(636) 441-7470
(636) 441-4270
Mailing address
4200 N CLOVERLEAF DR, SUITE B, SAINT PETERS, MO 63376-6436
(636) 441-7470
(636) 441-4270
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
684
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000002201
MERCY PREMIER
MO
01
—
192715
BLUE CROSS BLUE SHIELD
MO
Enumeration date
02/06/2007
Last updated
07/08/2007
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