Provider Demographics
NPI:1245336353
Name:KEVIN L.FOSTER
Entity type:Organization
Organization Name:KEVIN L.FOSTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-327-3100
Mailing Address - Street 1:801 MEDICAL DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385-3654
Mailing Address - Country:US
Mailing Address - Phone:636-327-3100
Mailing Address - Fax:636-639-5132
Practice Address - Street 1:801 MEDICAL DR
Practice Address - Street 2:SUITE 400
Practice Address - City:WENTZVILLE
Practice Address - State:MO
Practice Address - Zip Code:63385-3654
Practice Address - Country:US
Practice Address - Phone:636-327-3100
Practice Address - Fax:636-639-5132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty