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General NPI Number Information
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NPI Number | 1174071328
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Entity Type | Organization
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Legal Business Name | MISSOURIHEALTHPLUS
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Dates
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Enumeration Date | 09/16/2016
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Last Update Date | 09/16/2016
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Provider Practice Location Address
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Address Line | 7777 BONHOMME AVE SUITE 2300
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City | CLAYTON
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State | MO
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Zip | 63105-1911
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Country | US
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Telephone | 314-786-3330
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Fax |
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Provider Business Mailing Address
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Address Line | 7777 BONHOMME AVE SUITE 2300
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City | CLAYTON
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State | MO
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Zip | 63105-1911
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Country | US
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Telephone | 314-786-3330
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. DANNY O'NEILL
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Credential |
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Telephone | 314-786-3330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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