| James M. Whittico, Md, Llc | |
|
5535 Delmar Blvd Suite 2400 Saint Louis MO 63112-3005 | |
| (314) 367-3400 | |
| (314) 367-3408 |
| Full Name | James M. Whittico, Md, Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 5535 Delmar Blvd, Saint Louis, Missouri |
| Authorized Official Name and Position | James M. Whittico (COO) |
| Authorized Official Contact | 3143673400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| James M. Whittico, Md, Llc 5535 Delmar Blvd Suite 2400 Saint Louis MO 63112-3005 Ph: (314) 367-3400 | James M. Whittico, Md, Llc 5535 Delmar Blvd Suite 2400 Saint Louis MO 63112-3005 Ph: (314) 367-3400 |
| NPI Number | 1215187554 |
|---|---|
| Provider Enumeration Date | 09/23/2008 |
| Last Update Date | 09/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215187554 | NPI | - | NPPES |
| 200478303 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | MDRO700 (Missouri) | Primary |
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