Provider Demographics
NPI:1467925180
Name:METRO ST LOUIS SURGERY CENTER LLC
Entity Type:Organization
Organization Name:METRO ST LOUIS SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:DYSARZ
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:314-644-5152
Mailing Address - Street 1:1035 BELLEVUE AVE STE 117
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-1854
Mailing Address - Country:US
Mailing Address - Phone:314-644-5152
Mailing Address - Fax:314-644-5156
Practice Address - Street 1:1035 BELLEVUE AVE STE 117
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1854
Practice Address - Country:US
Practice Address - Phone:314-644-5152
Practice Address - Fax:314-644-5156
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SURGERY SPECIALIST OF ST. LOUIS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-04
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical