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NPI Code Detail

MEDICARE: WESTGLEN FAMILY PHYSICIANS, LLC

MEDICARE: WESTGLEN FAMILY PHYSICIANS, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2300XPrimary Care Clinic/Center

General Provider Information

NPI Number : 1235284597
Entity Type Code : Organization
Provider Name (Legal Business Name) : WESTGLEN FAMILY PHYSICIANS, LLC
Provider Business Mailing Address
First Line : 225 CLARKSON RD
Second Line :
City : ELLISVILLE
State : MO
Zip : 63011-2278
Country : US
Telephone Number : 636-230-5050
Fax Number :
Provider Business Practice Location Address
First Line : 225 CLARKSON RD
Second Line :
City : ELLISVILLE
State : MO
Zip : 63011-2278
Country : US
Telephone Number : 636-685-7715
Fax Number : 314-590-5916
Authorized Official
Title or Position : DIRECTOR
Name : RICK SONNE
Credential :
Telephone Number : 314-576-2490
Provider Enumeration Date : 01/24/2007
Last Update Date : 03/17/2018

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Directions to “WESTGLEN FAMILY PHYSICIANS, LLC ” Practice Location

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