Kevorkian, Rafi Thomas

Kevorkian, Rafi Thomas is an sole proprietor health care provider with primary practice located at 522 N New Ballas Rd Ste 317 , Saint Louis MO 63141-6840. He recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as his primary health care specialty. Kevorkian, Rafi Thomas can be contacted via phone (636) 634-5865.

Contact Information

Primary practice address
522 N New Ballas Rd Ste 317 Saint Louis MO 63141-6840
Phone: (636) 634-5865
Fax: (636) 688-8317
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 108134 Missouri

Profile Details

NPI number 1124073630
LBN Legal business name Kevorkian, Rafi Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 23rd, 2006
Last updated Oct 14th, 2015 - about 9 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 1124073630 NPPES
Missouri Other P00413101 RR MEDICARE
Missouri MEDICAID 205037823 RR MEDICARE

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