Provider Demographics
NPI:1164633939
Name:HUELSKOETTER, ELISABETH JANE (MD)
Entity Type:Individual
Prefix:DR
First Name:ELISABETH
Middle Name:JANE
Last Name:HUELSKOETTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:ELISABETH
Other - Middle Name:JANE
Other - Last Name:KLUG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:222 S WOODS MILL RD
Mailing Address - Street 2:SUITE 360 NORTH
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3625
Mailing Address - Country:US
Mailing Address - Phone:314-205-6788
Mailing Address - Fax:314-205-6786
Practice Address - Street 1:222 S WOODS MILL RD
Practice Address - Street 2:SUITE 360 NORTH
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3625
Practice Address - Country:US
Practice Address - Phone:636-489-0179
Practice Address - Fax:314-205-6786
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007007867207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology