Provider Demographics
NPI:1245580133
Name:STEPHENS OB GYN ASSOCIATES, LLC
Entity Type:Organization
Organization Name:STEPHENS OB GYN ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:SONNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-576-2490
Mailing Address - Street 1:121 SAINT LUKES CENTER DR
Mailing Address - Street 2:ATTN RICK SONNE
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3509
Mailing Address - Country:US
Mailing Address - Phone:314-576-2490
Mailing Address - Fax:314-576-2344
Practice Address - Street 1:226 S WOODS MILL RD
Practice Address - Street 2:STE 55W
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3662
Practice Address - Country:US
Practice Address - Phone:314-542-4953
Practice Address - Fax:314-590-5942
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. LUKE'S MEDICAL GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-18
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty