HODAG MEDICAL SERVICES, LLC – NPI #1003336819
Otolaryngology

An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions.

HODAG MEDICAL SERVICES, LLC is an otolaryngologist located in SAINT PETERS, MO. NPPES has assigned the NPI number 1003336819 to HODAG MEDICAL SERVICES, LLC on June 22, 2017. It is a Type-2 NPI, indicating this NPI number is associated with an organization. According to the NPI data, there are 2 additional location(s) assigned to this provider which are listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207YX0905X from the Health Care Provider Taxonomy code set, which is classified as Otolaryngology, specializing in Otolaryngology/Facial Plastic Surgery

The NPI profile was previously updated about 7 years ago on Aug 13, 2019. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for HODAG MEDICAL SERVICES, LLC below.

NPI Profile for
HODAG MEDICAL SERVICES, LLC

NPI Number
1003336819
Enumeration Date

(about 9 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
HODAG MEDICAL SERVICES, LLC
Primary location
4800 MEXICO RD STE 103
SAINT PETERS, MO 63376-1666
Phone: (636) 936-5002 Fax: (314) 821-5029
2 Other location(s):
12277 De Paul Dr Ste 303
Bridgeton, MO 63044-2529
Phone: (314) 770-0708
Fax: (314) 821-5029
2315 Dougherty Ferry Rd Ste 103
Saint Louis, MO 63122-3383
Phone: (314) 821-5002
Fax: (314) 821-5029
Mailing address
1324 CLARKSON CLAYTON CTR UNIT 301
ELLISVILLE, MO 63011-2145
Phone: (314) 541-6838 Fax:
Organization Subpart
No
Authorized Official
PAUL BURK
PHYSICIAN
Phone: (314) 821-5002
Updated
Identifiers

Identifiers for HODAG MEDICAL SERVICES, LLC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERNPI1790786838
MEDICAIDMO242428308
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207YX0905X
- Otolaryngology / Otolaryngology/Facial Plastic Surgery (Primary)
MO R6G71
207YX0602X
- Otolaryngology / Otolaryngic Allergy
MO R6G71

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.