Basic Information
Provider Information
NPI: 1174184774
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GESSERT
FirstName: CONNER
MiddleName: SCHWENT
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 660 S. EUCLID AVENUE
Address2: EMERGENCY MEDICINE
City: SAINT LOUIS
State: MO
PostalCode: 63110
CountryCode: US
TelephoneNumber: 3143625000
FaxNumber:  
Practice Location
Address1: 1 BARNES JEW HOSP PLZ
Address2:  
City: SAINT LOUIS
State: MO
PostalCode: 631101003
CountryCode: US
TelephoneNumber: 3143625000
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/25/2019
LastUpdateDate: 07/12/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/12/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X2019022197MON Allopathic & Osteopathic PhysiciansEmergency Medicine 
207P00000X2021025403MOY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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