Healthcare Provider Details

I. General information

NPI: 1134291388
Provider Name (Legal Business Name): NEUROSURGERY AND NEUROLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 SAINT LUKES CENTER DR STE 20B
CHESTERFIELD MO
63017-3509
US

IV. Provider business mailing address

232 S WOODS MILL RD
CHESTERFIELD MO
63017-3406
US

V. Phone/Fax

Practice location:
  • Phone: 636-685-7745
  • Fax: 314-576-8167
Mailing address:
  • Phone: 314-878-2888
  • Fax: 314-576-2433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: DARREN R. HASKELL
Title or Position: CHIEF MEDICAL OFFICER
Credential: MD.
Phone: 314-205-6444