=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932206935
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SPECIALISTS IN ONCOLOGY & HEMATOLOGY, P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/20/2006
-----------------------------------------------------
Last Update Date | 11/23/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4921 PARKVIEW PL STE 14B
-----------------------------------------------------
City | SAINT LOUIS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63110-1032
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-454-5580
-----------------------------------------------------
Fax | 314-454-5583
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4921 PARKVIEW PL STE 14B
-----------------------------------------------------
City | SAINT LOUIS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63110-1032
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-454-5580
-----------------------------------------------------
Fax | 314-454-5583
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | V.P.
-----------------------------------------------------
Name | BARBARA A HORN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 314-454-5580
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RH0003X
-----------------------------------------------------
Taxonomy Name | Hematology & Oncology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------