Healthcare Provider Details

I. General information

NPI: 1821043209
Provider Name (Legal Business Name): GAIL MOOLSINTONG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 09/21/2023
Certification Date: 09/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9701 LANDMARK PARKWAY DR STE 207
SAINT LOUIS MO
63127-1665
US

IV. Provider business mailing address

PO BOX 874797
KANSAS CITY MO
64187-4797
US

V. Phone/Fax

Practice location:
  • Phone: 314-849-8700
  • Fax: 314-849-8737
Mailing address:
  • Phone: 314-849-8700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2004008972
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2004008972
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: