Antisdel, Jastin L

Antisdel, Jastin L is an individual health care provider with primary practice located at 1225 S Grand Blvd Garden Level, Saint Louis MO 63104-1016. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Antisdel, Jastin L can be contacted via phone (314) 977-5110.

Contact Information

Primary practice address
1225 S Grand Blvd Garden Level Saint Louis MO 63104-1016
Phone: (314) 977-5110
Fax: (314) 977-7686
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 062018 Georgia
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 2005036993 Missouri

Profile Details

NPI number 1073714564
LBN Legal business name Antisdel, Jastin L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 30th, 2007
Last updated Jan 13th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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