Healthcare Provider Details
I. General information
NPI: 1215063110
Provider Name (Legal Business Name): ST LOUIS ONCOLOGY ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/26/2007
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10012 KENNERLY RD SUITE 100
SAINT LOUIS MO
63128-2197
US
IV. Provider business mailing address
10012 KENNERLY RD SUITE 100
SAINT LOUIS MO
63128-2197
US
V. Phone/Fax
- Phone: 314-849-6066
- Fax: 314-849-4038
- Phone: 314-849-6066
- Fax: 314-849-4038
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ROY
WILLIAM
MORRIS
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 314-849-6066