Provider Demographics
NPI:1326087792
Name:GENERAL SURGERY OF ST LOUIS PC
Entity Type:Organization
Organization Name:GENERAL SURGERY OF ST LOUIS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:BECKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-842-2226
Mailing Address - Street 1:12700 SOUTHFORK RD
Mailing Address - Street 2:SUITE 235
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-3201
Mailing Address - Country:US
Mailing Address - Phone:314-842-2226
Mailing Address - Fax:314-842-7977
Practice Address - Street 1:12700 SOUTHFORK RD
Practice Address - Street 2:SUITE 235
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-3201
Practice Address - Country:US
Practice Address - Phone:314-842-2226
Practice Address - Fax:314-842-7977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty