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General NPI Number Information
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NPI Number | 1427505197
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Entity Type | Individual
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Provider Name | KELLY KRISTA HYNES MD
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Gender | Female
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Dates
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Enumeration Date | 09/09/2016
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 1044 N MASON RD DEPT ORTHOPAEDIC SURGERY, STE 110/210
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City | SAINT LOUIS
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State | MO
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Zip | 63141-6431
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Country | US
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Telephone | 314-514-3500
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Fax | 314-878-7678
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Provider Business Mailing Address
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Address Line | PO BOX 7412011
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City | CHICAGO
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State | IL
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Zip | 60674-2011
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Country | US
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Telephone | 314-514-3500
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Fax | 314-878-7678
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number | 2024016199
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License Number State | MO
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