Provider Demographics
NPI:1174071328
Name:MISSOURIHEALTHPLUS
Entity type:Organization
Organization Name:MISSOURIHEALTHPLUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:
Authorized Official - Last Name:O'NEILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-786-3330
Mailing Address - Street 1:7777 BONHOMME AVE
Mailing Address - Street 2:SUITE 2300
Mailing Address - City:CLAYTON
Mailing Address - State:MO
Mailing Address - Zip Code:63105-1911
Mailing Address - Country:US
Mailing Address - Phone:314-786-3330
Mailing Address - Fax:
Practice Address - Street 1:7777 BONHOMME AVE
Practice Address - Street 2:SUITE 2300
Practice Address - City:CLAYTON
Practice Address - State:MO
Practice Address - Zip Code:63105-1911
Practice Address - Country:US
Practice Address - Phone:314-786-3330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-16
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty