Basic Information
| Provider Information | |||||||||
| NPI: | 1245336353 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | KEVIN L.FOSTER | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | TRI COUNTY WOMENS HEALTHCARE LLC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 801 MEDICAL DR | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | WENTZVILLE | ||||||||
| State: | MO | ||||||||
| PostalCode: | 633853654 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6363273100 | ||||||||
| FaxNumber: | 6366395132 | ||||||||
| Practice Location | |||||||||
| Address1: | 801 MEDICAL DR | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | WENTZVILLE | ||||||||
| State: | MO | ||||||||
| PostalCode: | 633853654 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6363273100 | ||||||||
| FaxNumber: | 6366395132 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2006 | ||||||||
| LastUpdateDate: | 06/11/2014 | ||||||||
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| AuthorizedOfficialLastName: | FOSTER | ||||||||
| AuthorizedOfficialFirstName: | ROY | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 6363273100 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.