Provider Demographics
NPI:1548430952
Name:TESSON HEIGHTS ORTHOPAEDIC & ARTHROSCOPIC ASSOCIATES PC
Entity Type:Organization
Organization Name:TESSON HEIGHTS ORTHOPAEDIC & ARTHROSCOPIC ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HELFERSTAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-849-5414
Mailing Address - Street 1:12152 TESSON FERRY RD
Mailing Address - Street 2:STE 2
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-1726
Mailing Address - Country:US
Mailing Address - Phone:314-849-5474
Mailing Address - Fax:314-849-2042
Practice Address - Street 1:12152 TESSON FERRY RD
Practice Address - Street 2:STE 2
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-1726
Practice Address - Country:US
Practice Address - Phone:314-849-5474
Practice Address - Fax:314-849-2042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000011602OtherMEDICARE
MO147331OtherGROUP HEALTH PLAN
MO147331OtherGROUP HEALTH PLAN