St Clair Allergy-Asthma

Organization Active NPI Specialist · St. Clair, MO

NPI 1225367337 · NPPES record last updated Jul 25, 2014

Key facts

NPI
1225367337
Entity type
Organization (NPI type 2)
Primary specialty
Specialist 174400000X
License
R3G15 (MO)
Legal business name
ST CLAIR ALLERGY-ASTHMA
Practice address
1020 St. Clair Plaza
St. Clair, MO 63077
Phone
(636) 629-6030
Fax
(636) 629-6030
NPI assigned
Dec 18, 2009
Organization subpart
No

Authorized official

Name
Dr. John D. Marcum, M.D.
Title
President
Phone
(636) 629-6030

National Provider Directory

Locations

111 E Main St
Park Hills, MO 63601
Phone (573) 431-5303

1020 Plaza Ct S
Saint Clair, MO 63077
Phone (636) 629-6030

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist
Group: 193400000X SINGLE SPECIALTY GROUP
174400000X R3G15 MO Yes

Addresses

Primary practice location

1020 St. Clair Plaza
St. Clair, MO 63077

Mailing address

13025 Pagada Pkwy
Saint Louis, MO 63127-1931
Phone (636) 629-6030

Other providers in St. Clair, MO

All providers in St. Clair, MO · Specialist in Missouri

Sources for this page

Verify at the official NPI Registry.