Provider Demographics
NPI:1033181268
Name:ALEXANDER T KALK, MD LLC
Entity Type:Organization
Organization Name:ALEXANDER T KALK, MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:T
Authorized Official - Last Name:KALK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-567-6464
Mailing Address - Street 1:522 N NEW BALLAS RD
Mailing Address - Street 2:SUITE 270
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6857
Mailing Address - Country:US
Mailing Address - Phone:314-567-6464
Mailing Address - Fax:314-567-6471
Practice Address - Street 1:522 N NEW BALLAS RD
Practice Address - Street 2:SUITE 270
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6857
Practice Address - Country:US
Practice Address - Phone:314-567-6464
Practice Address - Fax:314-567-6471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-02
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002021770207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty