Healthcare Provider Details

I. General information

NPI: 1568407849
Provider Name (Legal Business Name): CHENS RADIATION LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 08/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6420 CLAYTON RD DEPT. OF RADIATION ONCOLOGY
SAINT LOUIS MO
63117-1811
US

IV. Provider business mailing address

14014 CAMBERRA CT
CHESTERFIELD MO
63017-3305
US

V. Phone/Fax

Practice location:
  • Phone: 314-768-8267
  • Fax: 314-768-7142
Mailing address:
  • Phone: 314-768-8267
  • Fax: 314-768-7142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberNA
License Number StateMO

VIII. Authorized Official

Name: DR. JAMES Z. CHEN
Title or Position: PRESIDENT
Credential: MD
Phone: 314-768-8267