Provider Demographics
NPI:1689261885
Name:VERITAS FERTILITY AND SURGERY
Entity Type:Organization
Organization Name:VERITAS FERTILITY AND SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GAVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PUTHOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-405-9556
Mailing Address - Street 1:522 N NEW BALLAS RD STE 300
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6840
Mailing Address - Country:US
Mailing Address - Phone:314-405-9556
Mailing Address - Fax:201-595-0290
Practice Address - Street 1:522 N NEW BALLAS RD STE 300
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6840
Practice Address - Country:US
Practice Address - Phone:314-405-9556
Practice Address - Fax:201-595-0290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-22
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty