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Specialty details in registry · Saint Louis, MO

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At a glance

321 Averill Ave, Saint Louis, MO 63135-2839

NPPES record updated Jan 26, 2026. Public records can lag behind changes at a practice.

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  • Are you accepting new patients?
  • Do you accept my specific insurance plan?
  • Do you provide the service I need at this address?
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Insurance participation and appointment availability are not established by these public records.

Practice location

321 Averill Ave
Saint Louis, MO 63135-2839
Professional details: NPI, taxonomy & registry record
NPI1194674838
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
364ST0500X
Enumeration date
Jan 26, 2026
Record updated
Jan 26, 2026
More registry details
Provider type
Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

364ST0500X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

321 Averill Ave
Saint Louis, MO 63135-2839
Phone
(314) 749-3263
Mailing address
321 AVERILL AVE

SAINT LOUIS, MO 631352839
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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