Jim, Jeffrey

Jim, Jeffrey is an individual health care provider with primary practice located at 4921 Parkview Pl Ste 8A Ste 8A, Saint Louis MO 63110-1032. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Jim, Jeffrey can be contacted via phone (314) 362-6519.

Contact Information

Primary practice address
4921 Parkview Pl Ste 8A Ste 8A Saint Louis MO 63110-1032
Phone: (314) 362-6519
Fax: (314) 362-4615
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 2010015658 Missouri

Profile Details

NPI number 1568602886
LBN Legal business name Jim, Jeffrey
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 26th, 2009
Last updated Jan 24th, 2018 - about 6 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 1568602886 NPPES
Illinois MEDICAID ENROLLED
Illinois MEDICAID 1568602886

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