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Contact Information

EAR NOSE & THROAT & PLASTIC SURG INC
2325 DOUGHERTY FERRY RD STE 106
SAINT LOUIS, MO63122-3356
 Phone: 314-821-5002
 Fax: 314-821-5029
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Facial Plastic Surgery

207YS0123X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for EAR NOSE THROAT PLASTIC SURG INC · (Female)

NPI Number 1104911288
Status Active
Credentials
Entity Individual
Enumeration date 10/04/2006
Last updated 10/09/2025 - About 8 months ago
Sole proprietor 1 Not specified
Identifiers
  • MO Medicaid 502754401
  • MO Other 040003579 MEDICARE RAILROAD
  • MO Other 040010750 MEDICARE RAILROAD
  • MO Other 040017959 MEDICARE RAILROAD
  • MO Other CP2222 MEDICARE RAILROAD
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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