| Kevin L. Threlkeld, M.d., Llc | |
|
204 N Main St O Fallon MO 63366-2203 | |
| (636) 240-3420 | |
| Not Available |
| Full Name | Kevin L. Threlkeld, M.d., Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 204 N Main St, O Fallon, Missouri |
| Authorized Official Name and Position | Kevin L Threlkeld (PHYSICIAN REGISTERED AGENT) |
| Authorized Official Contact | 6363901854 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin L. Threlkeld, M.d., Llc Po Box 270003 Saint Louis MO 63127-0003 Ph: (636) 390-1854 | Kevin L. Threlkeld, M.d., Llc 204 N Main St O Fallon MO 63366-2203 Ph: (636) 240-3420 |
| NPI Number | 1023195351 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 10/10/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023195351 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MDR5P58 (Missouri) | Primary |
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