MEDICARE: WILLIAM TSCHANNEN PA-C

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
1	363A00000X	Physician Assistant	2021009626	MO
2	363AM0700X	Medical Physician Assistant	2021009626	MO

General Provider Information

NPI Number	:	1427651967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM TSCHANNEN PA-C

Provider Business Mailing Address
First Line	:	PO BOX 959354
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63195-9354
Country	:	US
Telephone Number	:	314-996-5900
Fax Number	:	314-996-5910

Provider Business Practice Location Address
First Line	:	3009 N BALLAS RD STE 390C
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63131-2322
Country	:	US
Telephone Number	:	314-996-5900
Fax Number	:	314-996-5910

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2020
Last Update Date	:	12/18/2025

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Directions to “ WILLIAM TSCHANNEN PA-C” Practice Location

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