MEDICARE: SLH PHYSICIANS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician
2	207P00000X	Emergency Medicine Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DE0426	OTHER	MO	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881668051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SLH PHYSICIANS LLC

Provider Business Mailing Address
First Line	:	3635 VISTA AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-2539
Country	:	US
Telephone Number	:	314-577-8000
Fax Number	:	314-577-8003

Provider Business Practice Location Address
First Line	:	3635 VISTA AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-2539
Country	:	US
Telephone Number	:	314-577-8000
Fax Number	:	314-577-8003

Authorized Official
Title or Position	:	SVP, REGIONAL OPERATIONS TENET
Name	:	MR. TIMOTHY ADAMS
Credential	:
Telephone Number	:	469-893-2563

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	07/28/2016

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Directions to “SLH PHYSICIANS LLC ” Practice Location

Language	Start Address	Practice Location

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