Organization · Type 2 NPI

St. Louis Vascular Surgical Specialists PC

Vascular Surgery Physician · Lake St. Louis, MO

NPI number 1477246312 Active

Practice location

1901 Hrc Plaza Dr
Lake St. Louis, MO 63367-2360

Fax (314) 755-1184

Specialties and licenses

Taxonomy	Code	License
Internal Medicine Physician	207R00000X	None listed
Vascular Surgery Physician Primary	2086S0129X	None listed

Vascular Surgery Physician: A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

NPI record

NPI: 1477246312
Entity type: Organization (Type 2)
Issued: May 26, 2023
Last updated: Jun 5, 2026
Status: Active

Other names

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St. Louis Limb Preservation Center · doing business as
St. Louis Limb Preservation Center · doing business as
St. Louis Vascular Surgery Specialists · doing business as

Authorized official

Dr. Robert Ivan Hacker, MD
CEO Owner
(314) 755-1084

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About NPI 1477246312

St. Louis Vascular Surgical Specialists PC's National Provider Identifier is 1477246312, issued on May 26, 2023. The primary taxonomy on file is Vascular Surgery Physician (2086S0129X), and the practice location is in Lake St. Louis, MO. The record was last updated on Jun 5, 2026.