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General NPI Number Information
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NPI Number | 1568287076
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Entity Type | Organization
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Legal Business Name | ONYX SPINE AND ORTHOPEDIC AMBULATORY SURGERY CENTER LLC
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Dates
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Enumeration Date | 11/19/2024
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 211 N LINDBERGH BLVD STE 101
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City | CREVE COEUR
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State | MO
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Zip | 63141-7838
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Country | US
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Telephone | 314-266-2066
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Fax |
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Provider Business Mailing Address
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Address Line | 425 N NEW BALLAS RD STE 230
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City | SAINT LOUIS
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State | MO
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Zip | 63141-6848
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Country | US
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Telephone | 314-266-2066
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Fax | 314-266-2069
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. DAVID MINGES
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Credential | MD
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Telephone | 314-266-2066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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