Organization Active NPI

Joseph M Duvall MD LLC

  • Dermatology Physician
  • Saint Louis, MO
National Provider Identifier
1053414227
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
R6127 Issued in MO
Legal business name
JOSEPH M DUVALL MD LLC
Practice address
621 S New Ballas Rd
5002B
St Louis, MO 63141
Phone
(314) 432-3033
Fax
(314) 995-9985
NPI assigned
Sep 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Joseph M Duvall, MD
Title
MD
Phone
(314) 432-5112

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X R6127 MO Primary

Addresses

Primary practice location

621 S New Ballas Rd
5002B
St Louis, MO 63141

Mailing address

621 S New Ballas Rd
5002B
St Louis, MO 63141
Phone (314) 432-3033

Other identifiers 1

IdentifierTypeStateIssuer
000013588OtherMOMEDICARE ID- TYPE UNSPECI

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196294400000",
    "number": "1053414227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "5002B",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63141",
            "telephone_number": "314-432-3033",
            "fax_number": "314-995-9985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "5002B",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63141",
            "telephone_number": "314-432-3033",
            "fax_number": "314-995-9985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH M DUVALL MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-11-29",
        "status": "A",
        "authorized_official_last_name": "DUVALL",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "314-432-5112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "MO",
            "license": "R6127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID- TYPE UNSPECI",
            "identifier": "000013588",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.