Healthcare Provider Details

I. General information

NPI: 1295505667
Provider Name (Legal Business Name): NATHAN A OATIS MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2024
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4444 FOREST PARK AVE STE 2600
SAINT LOUIS MO
63108-2212
US

IV. Provider business mailing address

PO BOX 60352
SAINT LOUIS MO
63160-0352
US

V. Phone/Fax

Practice location:
  • Phone: 314-286-1700
  • Fax: 314-362-7017
Mailing address:
  • Phone: 314-286-1700
  • Fax: 314-362-7017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2021049186
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: