Healthcare Provider Details

I. General information

NPI: 1487587085
Provider Name (Legal Business Name): MORGAN ROSE WILT TIMM MD, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4901 FOREST PARK AVE STE 710
SAINT LOUIS MO
63108-1495
US

IV. Provider business mailing address

4901 FOREST PARK AVE STE 710
SAINT LOUIS MO
63108-1495
US

V. Phone/Fax

Practice location:
  • Phone: 314-362-4211
  • Fax:
Mailing address:
  • Phone: 314-362-4211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: