Provider Demographics
NPI:1730342163
Name:EMERGENCY PHYSICIANS OF ST. LOUIS, PC
Entity type:Organization
Organization Name:EMERGENCY PHYSICIANS OF ST. LOUIS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHLAUTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-550-0003
Mailing Address - Street 1:PO BOX 790379
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63179-0379
Mailing Address - Country:US
Mailing Address - Phone:816-550-0003
Mailing Address - Fax:630-734-1560
Practice Address - Street 1:10010 KENNERLY ROAD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128
Practice Address - Country:US
Practice Address - Phone:816-550-0003
Practice Address - Fax:630-734-1560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-07
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Single Specialty