Basic Information
| Provider Information | |||||||||
| NPI: | 1730206665 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BARNES JEWISH HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1511 LOCUST ST | ||||||||
| Address2: | UNIT 201 | ||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631031843 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6462297363 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 BARNES JEWISH HOSPITAL PLZ | ||||||||
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| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631101003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3143625000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | JOHNSON | ||||||||
| AuthorizedOfficialFirstName: | KEVIN | ||||||||
| AuthorizedOfficialMiddleName: | MAURICE | ||||||||
| AuthorizedOfficialTitleorPosition: | RESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3143622978 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 2004015400 | MO | Y | Hospitals | General Acute Care Hospital |
No ID Information.