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General NPI Number Information
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NPI Number | 1356316103
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Entity Type | Organization
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Legal Business Name | MERCY ARCH HEMATOLOGY ONCOLOGY GROUP INC.
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Dates
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Enumeration Date | 02/22/2006
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Last Update Date | 02/04/2010
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Provider Practice Location Address
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Address Line | 607 S NEW BALLAS RD SUITE 3300
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City | SAINT LOUIS
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State | MO
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Zip | 63141-8219
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Country | US
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Telephone | 314-251-4986
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Fax | 314-251-6375
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Provider Business Mailing Address
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Address Line | 607 S NEW BALLAS RD SUITE 3300
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City | SAINT LOUIS
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State | MO
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Zip | 63141-8219
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Country | US
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Telephone | 314-251-4986
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Fax | 314-251-6375
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Authorized Official
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Title or Position | PRESIDENT
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Name | BURTON M NEEDLES
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Credential | M.D.
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Telephone | 314-251-4986
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State | MO
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