| South St Louis Medical Associates Llc | |
|
3915 Watson Rd Suite 100 Saint Louis MO 63109-1251 | |
| (314) 881-0300 | |
| (314) 881-0321 |
| Full Name | South St Louis Medical Associates Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3915 Watson Rd, Saint Louis, Missouri |
| Authorized Official Name and Position | James S Compton (PHYSICIAN) |
| Authorized Official Contact | 3148810300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South St Louis Medical Associates Llc Po Box 445 Sullivan MO 63080-0445 Ph: (888) 371-0337 | South St Louis Medical Associates Llc 3915 Watson Rd Suite 100 Saint Louis MO 63109-1251 Ph: (314) 881-0300 |
| NPI Number | 1750681151 |
|---|---|
| Provider Enumeration Date | 11/01/2010 |
| Last Update Date | 09/26/2018 |
| Medicare PECOS PAC ID | 1153510888 |
|---|---|
| Medicare Enrollment ID | O20110112000376 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750681151 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | R2D22 (Missouri) | Primary |
| Provider Name | Kamlesh C Vyas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679551378 PECOS PAC ID: 3173540366 Enrollment ID: I20051027000301 |
| Provider Name | James S Compton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336133321 PECOS PAC ID: 4981794724 Enrollment ID: I20100326000923 |
| Provider Name | Allyse Ortega |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982149878 PECOS PAC ID: 4486930732 Enrollment ID: I20170420002571 |
| Provider Name | Allison Dolan-boschert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659922946 PECOS PAC ID: 4587096391 Enrollment ID: I20191118000077 |
| Provider Name | Jolene Marie Cabral |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659988517 PECOS PAC ID: 0244650133 Enrollment ID: I20201014002596 |
| Provider Name | Candace Meagan Laplant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073219739 PECOS PAC ID: 6103284187 Enrollment ID: I20230623000377 |
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