Provider Demographics
NPI:1629439187
Name:ST. LOUIS ELECTROPHYSIOLOGY SPECIALISTS, LLC
Entity Type:Organization
Organization Name:ST. LOUIS ELECTROPHYSIOLOGY SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V. P. PHYSICIAN NETWORK
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:SNIDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-685-7804
Mailing Address - Street 1:121 SAINT LUKES CENTER DR STE 501
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3519
Mailing Address - Country:US
Mailing Address - Phone:636-685-7738
Mailing Address - Fax:314-590-5927
Practice Address - Street 1:121 SAINT LUKES CENTER DR STE 501
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3519
Practice Address - Country:US
Practice Address - Phone:636-685-7738
Practice Address - Fax:314-590-5927
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. LUKE'S MEDICAL GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-03-11
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Single Specialty