Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mattis Road Surgery Center LLC

Organization Surgery Physician · NPI 1720969504

Mattis Road Surgery Center LLC is a Surgery Physician in Saint Louis, Missouri. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

5139 Mattis Rd Ste 100
Saint Louis, MO 63128-2250
Phone: (314) 952-8001
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X

Record details

NPI number1720969504
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official John Kessler — Administrator · (314) 952-8001
NPI enumeratedSeptember 9, 2025
Last updated in NPPESSeptember 9, 2025
Certification dateSeptember 9, 2025
Mailing address5139 Mattis Rd Ste 100, Saint Louis, MO 63128-2250

Other providers in Saint Louis