Heusel, Jonathan W

Heusel, Jonathan W is an individual health care provider with primary practice located at 4320 Forest Park Ave Ste 209, Saint Louis MO 63108-2979. He recently has only one registered license in Allopathic & Osteopathic Physicians / Molecular Genetic Pathology, which is considered as his primary health care specialty. Heusel, Jonathan W can be contacted via phone (314) 362-5641.

Contact Information

Primary practice address
4320 Forest Park Ave Ste 209 Saint Louis MO 63108-2979
Phone: (314) 362-5641
Fax: (314) 362-0369
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Molecular Genetic Pathology 207ZP0007X 108616 Missouri

Profile Details

NPI number 1255329058
LBN Legal business name Heusel, Jonathan W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 6th, 2005
Last updated Nov 15th, 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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Identifiers

StateTypeNumberIssuer
All States NPI 1255329058 NPPES
Missouri MEDICAID 1043414113

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