Healthcare Provider Details

I. General information

NPI: 1609454784
Provider Name (Legal Business Name): LUKE HARRISON HEIL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHILDRENS PL MSC 8116-0043-14
ST. LOUIS MO
63110
US

IV. Provider business mailing address

1 CHILDRENS PL MSC 8116-0043-14
ST LOUIS MO
63110
US

V. Phone/Fax

Practice location:
  • Phone: 859-218-2509
  • Fax: 859-323-3499
Mailing address:
  • Phone: 314-454-2694
  • Fax: 844-231-8913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2026010226
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: