Healthcare Provider Details
I. General information
NPI: 1346228202
Provider Name (Legal Business Name): ON CALL PHYSICIANS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/02/2006
Last Update Date: 12/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2331 HAMPTON AVE
SAINT LOUIS MO
63139-2908
US
IV. Provider business mailing address
2331 HAMPTON AVE
SAINT LOUIS MO
63139-2908
US
V. Phone/Fax
- Phone: 314-647-7200
- Fax: 314-646-0920
- Phone: 314-647-7200
- Fax: 314-646-0920
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207PE0004X |
| Taxonomy | Emergency Medical Services (Emergency Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DEVON
N
GOLDING
Title or Position: PRESIDENT
Credential: MD
Phone: 314-772-1441