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General NPI Number Information
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NPI Number | 1649429945
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Entity Type | Organization
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Legal Business Name | DES PERES HOSPITAL
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Dates
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Enumeration Date | 09/11/2008
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Last Update Date | 09/11/2008
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Provider Practice Location Address
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Address Line | 12442 BENNETT SPRINGS COURT
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City | SAINT LOUIS
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State | MO
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Zip | 63146
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Country | US
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Telephone | 314-966-9100
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Fax |
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Provider Business Mailing Address
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Address Line | 12442 BENNETT SPRINGS CT
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City | SAINT LOUIS
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State | MO
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Zip | 63146-3920
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Country | US
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Telephone | 314-966-9100
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Fax |
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Authorized Official
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Title or Position | RESIDENT PHYSICIAN
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Name | DAN T BRANNON
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Credential | D.O.
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Telephone | 314-966-9377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State | MO
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