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General NPI Number Information
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NPI Number | 1528192416
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Entity Type | Organization
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Legal Business Name | MERCY CLINIC CARDIOVASCULAR AND THORACIC SURGERY, LLC
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 02/19/2026
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Provider Practice Location Address
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Address Line | 851 E 5TH ST SUITE 304
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City | WASHINGTON
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State | MO
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Zip | 63090-3135
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Country | US
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Telephone | 314-251-6970
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Fax | 314-251-1053
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Provider Business Mailing Address
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Address Line | 625 S NEW BALLAS RD STE R-7040
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City | SAINT LOUIS
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State | MO
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Zip | 63141-8240
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Country | US
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Telephone | 314-251-6970
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Fax | 314-251-1053
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Authorized Official
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Title or Position | CFO
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Name | JONATHAN TYLER STURGEON
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Credential |
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Telephone | 314-251-1917
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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