Individual
DR. JONATHAN POLLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 S NEW BALLAS RD STE 310, SAINT LOUIS, MO 63141-8725
(314) 251-8750
(314) 251-8751
Mailing address
701 S NEW BALLAS RD STE 310, SAINT LOUIS, MO 63141-8725
(314) 251-8750
(314) 251-8751
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
2004002424
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972572360
—
MO
01
—
P00283056
RAILROAD MEDICARE
MO
Enumeration date
03/16/2006
Last updated
09/06/2023
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