Connor Scott Corcoran, MD | |
100 Medical Plz, Lake Saint Louis, MO 63367-1366 | |
(314) 628-4095 | |
Not Available |
Full Name | Connor Scott Corcoran |
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Gender | Male |
Speciality | Pediatrics |
Location | 100 Medical Plz, Lake Saint Louis, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1205298593 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 2023004964 (Missouri) | Primary |
Entity Name | Ssm Health Care St Louis |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1275586174 PECOS PAC ID: 7810800737 Enrollment ID: O20031118000393 |
Entity Name | Ssm Cardinal Glennon Children's Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1174577670 PECOS PAC ID: 7012828163 Enrollment ID: O20031231000604 |
Mailing Address | Practice Location Address |
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Connor Scott Corcoran, MD 1465 S Grand Blvd, Saint Louis, MO 63104-1003 Ph: (314) 268-4095 | Connor Scott Corcoran, MD 100 Medical Plz, Lake Saint Louis, MO 63367-1366 Ph: (314) 628-4095 |
Jason Gutting, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 100 Medical Plz, Lake Saint Louis, MO 63367 Phone: 636-625-5200 | |
Dr. Richard A Felkel, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 100 Brevco Plz, Ste 101, Lake Saint Louis, MO 63367 Phone: 636-561-5437 Fax: 636-561-5100 | |
Dr. Kris Ann Roberts, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 100 Brevco Plz, Ste 101, Lake Saint Louis, MO 63367 Phone: 636-561-5437 Fax: 636-561-5100 |