Provider Demographics
NPI:1073799292
Name:PLASTIC SURGERY CENTER OF ST LOUIS PC
Entity Type:Organization
Organization Name:PLASTIC SURGERY CENTER OF ST LOUIS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:C
Authorized Official - Last Name:RINEHART
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-984-0461
Mailing Address - Street 1:1001 S KIRKWOOD RD
Mailing Address - Street 2:STE 160
Mailing Address - City:KIRKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63122-7254
Mailing Address - Country:US
Mailing Address - Phone:314-984-0461
Mailing Address - Fax:314-909-8981
Practice Address - Street 1:1001 S KIRKWOOD RD
Practice Address - Street 2:STE 160
Practice Address - City:KIRKWOOD
Practice Address - State:MO
Practice Address - Zip Code:63122-7254
Practice Address - Country:US
Practice Address - Phone:314-984-0461
Practice Address - Fax:314-909-8981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-17
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR2H37174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty