Organization · Type 2 NPI

ST Louis University

Facial Plastic Surgery Physician · St. Louis, MO

NPI number 1023220910 Active

Practice location

1225 South Grand, Gl, Door 3
St. Louis, MO 63104-6310

Call (314) 977-5119 Map

Mailing address

3545 Lindell Blvd Fl 3
St. Louis, MO 63103-1020

Other practice locations

3660 Vista Ave, St. Louis, MO 63110-2540 · (314) 977-5110

Specialties and licenses

Taxonomy	Code	License
Facial Plastic Surgery Physician Primary	207YS0123X	None listed

Facial Plastic Surgery Physician: An otolaryngologist who specializes in facial plastic surgery.

10 other providers at this address

Other facial plastic surgery physician providers in St. Louis

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NPI record

NPI: 1023220910
Entity type: Organization (Type 2)
Issued: May 4, 2007
Last updated: Sep 21, 2021
Status: Active

Other names

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Slucare Dept of Otolaryngology-Facial Plastic Surgery · doing business as
Slucare Dept of Otolaryngology-Facial Plastic Surgery · doing business as

Authorized official

Alyce Lanxon
Executive Director
(314) 977-6828

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About NPI 1023220910

ST Louis University's National Provider Identifier is 1023220910, issued on May 4, 2007. The primary taxonomy on file is Facial Plastic Surgery Physician (207YS0123X), and the practice location is in St. Louis, MO. The record was last updated on Sep 21, 2021.