Healthcare Provider Details

I. General information

NPI: 1992722409
Provider Name (Legal Business Name): WILLIAM F STENSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 11/15/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4921 PARKVIEW PL DIV IM GASTROENTEROLOGY, STE 10B
SAINT LOUIS MO
63110-1032
US

IV. Provider business mailing address

660 S EUCLID AVE CB 8124
SAINT LOUIS MO
63110-1010
US

V. Phone/Fax

Practice location:
  • Phone: 314-747-2066
  • Fax: 314-362-2357
Mailing address:
  • Phone: 314-454-8160
  • Fax: 314-747-1277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberR5299
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: