Healthcare Provider Details

I. General information

NPI: 1811046949
Provider Name (Legal Business Name): MISSOURI HEMATOLOGY & ONCOLOGY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 CLAYTON RD SUITE 302
SAINT LOUIS MO
63117-1850
US

IV. Provider business mailing address

6400 CLAYTON RD SUITE 302
SAINT LOUIS MO
63117-1850
US

V. Phone/Fax

Practice location:
  • Phone: 314-645-3432
  • Fax: 314-645-3191
Mailing address:
  • Phone: 314-645-3432
  • Fax: 314-645-3191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number StateMO

VIII. Authorized Official

Name: DR. STEPHEN K JANNEY
Title or Position: PRESIDENT
Credential: M.D.
Phone: 314-645-3432