Botteron, Kelly N

Botteron, Kelly N is an individual health care provider with primary practice located at 4444 Forest Park Ave Ste 2600, Saint Louis MO 63108-2212. She recently has only one registered license in Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, which is considered as her primary health care specialty. Botteron, Kelly N can be contacted via phone (314) 286-1700.

Contact Information

Primary practice address
4444 Forest Park Ave Ste 2600 Saint Louis MO 63108-2212
Phone: (314) 286-1700
Fax: (314) 286-1777
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X R3P75 Missouri

Profile Details

NPI number 1013952860
LBN Legal business name Botteron, Kelly N
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2006
Last updated Nov 15th, 2021 - about 5 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 1013952860 NPPES
Missouri MEDICAID 203692009

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