Provider Demographics
NPI:1972778553
Name:SURGEON'S FIRST CHOICE, L.L.C.
Entity Type:Organization
Organization Name:SURGEON'S FIRST CHOICE, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERIFIED RN FIRST ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:KELLER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:636-397-4512
Mailing Address - Street 1:543 MINUS DR
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-4089
Mailing Address - Country:US
Mailing Address - Phone:636-397-4512
Mailing Address - Fax:
Practice Address - Street 1:543 MINUS DR
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-4089
Practice Address - Country:US
Practice Address - Phone:636-397-4512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO079627163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty