Provider Demographics
NPI:1184298523
Name:TSANG, HENRY (DO)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:
Last Name:TSANG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:'PO BOX 959203 ST LOUIS MO 63195'
Mailing Address - Street 2:SL-T10P
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63195-0001
Mailing Address - Country:US
Mailing Address - Phone:618-257-6220
Mailing Address - Fax:618-257-6679
Practice Address - Street 1:4500 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62226-5360
Practice Address - Country:US
Practice Address - Phone:618-257-6220
Practice Address - Fax:618-257-6679
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL83595207Q00000X
IL036043258208M00000X
IL036176163208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine