| St. Luke's Family Medicine - Maryland Heights Llc | |
|
915 Fee Fee Rd Maryland Heights MO 63043-3801 | |
| (314) 770-1777 | |
| (314) 590-5952 |
| Full Name | St. Luke's Family Medicine - Maryland Heights Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 915 Fee Fee Rd, Maryland Heights, Missouri |
| Authorized Official Name and Position | Darren Haskell (VP PHYSICIAN NETWORK) |
| Authorized Official Contact | 3142056444 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Luke's Family Medicine - Maryland Heights Llc 915 Fee Fee Rd Maryland Heights MO 63043-3801 Ph: (636) 685-7804 | St. Luke's Family Medicine - Maryland Heights Llc 915 Fee Fee Rd Maryland Heights MO 63043-3801 Ph: (314) 770-1777 |
| NPI Number | 1902197767 |
|---|---|
| Provider Enumeration Date | 04/28/2011 |
| Last Update Date | 09/26/2024 |
| Medicare PECOS PAC ID | 5597942193 |
|---|---|
| Medicare Enrollment ID | O20110608000289 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902197767 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Terri L Carron |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881636439 PECOS PAC ID: 5092843912 Enrollment ID: I20100513000188 |
| Provider Name | Sarah R Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083044879 PECOS PAC ID: 1052541166 Enrollment ID: I20140310001972 |
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