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Search › Missouri › Surgical Physician Assistant

Keith Wiethaupt

NPI 1801718788 · on the registry since 2026 · sole proprietor

Practice

Address
7827 Town Square Ave Ste 104
O Fallon, MO 63368
Phone
(636) 734-0386
Fax
(636) 352-4173
Organisation at this address
Union Counselors, Llc
Authentic Life Counseling Llc
Dental Safari Co Missouri, Pc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
11

Registry record

Primary taxonomy
Surgical Physician Assistant
363AS0400X
Licence states on file
MO
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2026-07-29

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Missouri