Provider Demographics
NPI:1972854032
Name:WEST COUNTY OBGYN SPECIALISTS, PC
Entity Type:Organization
Organization Name:WEST COUNTY OBGYN SPECIALISTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PIGNOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-251-7564
Mailing Address - Street 1:621 SOUTH NEW BALLAS ROAD, SUITE 75 B
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141
Mailing Address - Country:US
Mailing Address - Phone:314-251-7564
Mailing Address - Fax:314-251-7554
Practice Address - Street 1:621 S NEW BALLAS RD STE 75B
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8251
Practice Address - Country:US
Practice Address - Phone:314-251-7564
Practice Address - Fax:314-251-7554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012012819207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty