Provider Demographics
NPI:1508164724
Name:H L S MEDICAL LLC
Entity Type:Organization
Organization Name:H L S MEDICAL LLC
Other - Org Name:HILLARD L SCOTT M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:GERALDINE
Authorized Official - Middle Name:CLAYBORNE
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-382-8899
Mailing Address - Street 1:3645 OAKMOUNT AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63121-4906
Mailing Address - Country:US
Mailing Address - Phone:314-382-8899
Mailing Address - Fax:314-382-4002
Practice Address - Street 1:3645 OAKMOUNT AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63121-4906
Practice Address - Country:US
Practice Address - Phone:314-382-8899
Practice Address - Fax:314-382-4002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-11
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO36144207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty