Provider Demographics
NPI: | 1285750497 |
---|---|
Name: | PSYCHIATRIC CONSULTANTS L.T.D. |
Entity type: | Organization |
Organization Name: | PSYCHIATRIC CONSULTANTS L.T.D. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | ADMINISTRATOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | IRSHAD |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | KHAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 314-843-4333 |
Mailing Address - Street 1: | 5000 CEDAR PLAZA PKWY |
Mailing Address - Street 2: | SUITE 350 |
Mailing Address - City: | SAINT LOUIS |
Mailing Address - State: | MO |
Mailing Address - Zip Code: | 63128-3854 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 314-843-4333 |
Mailing Address - Fax: | 314-843-4856 |
Practice Address - Street 1: | 5000 CEDAR PLAZA PKWY |
Practice Address - Street 2: | SUITE 350 |
Practice Address - City: | SAINT LOUIS |
Practice Address - State: | MO |
Practice Address - Zip Code: | 63128-3854 |
Practice Address - Country: | US |
Practice Address - Phone: | 314-843-4333 |
Practice Address - Fax: | 314-843-4856 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-03-21 |
Last Update Date: | 2008-06-25 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | Group - Single Specialty |