Healthcare Provider Details

I. General information

NPI: 1215950233
Provider Name (Legal Business Name): KATHRYN L PLAX MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHILDRENS PL DIV PED, ADOLESCENT MEDICINE
SAINT LOUIS MO
63110-1002
US

IV. Provider business mailing address

PO BOX 60352
SAINT LOUIS MO
63160-0352
US

V. Phone/Fax

Practice location:
  • Phone: 314-454-2468
  • Fax: 314-454-2524
Mailing address:
  • Phone: 314-454-2468
  • Fax: 314-454-2524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number113154
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number35C.003452
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number113154
License Number StateMO
# 4
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number35C.003452
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35C.003452
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: