Provider Demographics
NPI:1437146784
Name:WEST COUNTY SURGICALSPECIALIST
Entity Type:Organization
Organization Name:WEST COUNTY SURGICALSPECIALIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-251-6840
Mailing Address - Street 1:621 S NEW BALLAS RD
Mailing Address - Street 2:SUITE 7011B
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8232
Mailing Address - Country:US
Mailing Address - Phone:314-251-6840
Mailing Address - Fax:314-251-7249
Practice Address - Street 1:621 S NEW BALLAS RD
Practice Address - Street 2:SUITE 7011B
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8232
Practice Address - Country:US
Practice Address - Phone:314-251-6840
Practice Address - Fax:314-251-7249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-03
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOCQ2324OtherRAILROAD MEDICARE GROUP