Gerald Mahon
Geriatric Medicine
1201 S Grand Blvd
Saint Louis
, Missouri 63104-1016
Gerald Mahon
Geriatric Medicine
1201 S Grand Blvd
Saint Louis
, Missouri 63104-1016
(314) 977-3370
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About
Features
Specialties
- Geriatric Medicine
Languages spoken
- English
Location
First Address
- Gerald Mahon
- 1008 S Spring Ave Fl 2
- Saint Louis, MO
- Zip : 63110-2520
- Fax : (314) 977-3370
- Phone : (314) 977-8462
Second Address
- Gerald Mahon
- 1201 S Grand Blvd
- Saint Louis, MO
- Zip : 63104-1016
- Fax : (314) 977-3370
- Phone : (314) 977-8462
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RG0300X | Geriatric Medicine | R4H74 | MO |
National Provider Identifier
| NPI | 1154302289 |
|---|---|
| Provider Name | Gerald Mahon |
| First Address | Saint Louis, MO 63110-2520 |
| Second Address | Saint Louis, MO 63104-1016 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/11/2005 |
| Last Update Date | 12/03/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000000011339 | ESSENCE (01) | MO |
| 0400402 | UHC (01) | MO |
| 138654 | HEALTHLINK (01) | MO |
| 17644 | BCBS (01) | MO |
| 39965 | GHP (01) | MO |
| 4136351 | AETNA (01) | MO |
| A12432 | (02) | MO |
| A12432 | MERCY (01) | MO |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.