| Joule N Stevenson MD LLC | |
|
12277 De Paul Dr Suite 406 Bridgeton MO 63044-2516 | |
| (314) 731-7844 | |
| (314) 731-3296 |
| Full Name | Joule N Stevenson MD LLC |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 12277 De Paul Dr, Bridgeton, Missouri |
| Authorized Official Name and Position | Joule N Stevenson (PHYSICIAN OWNER) |
| Authorized Official Contact | 3147317844 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Joule N Stevenson MD LLC 12277 De Paul Dr Suite 406 Bridgeton MO 63044-2516 Ph: (314) 731-7844 | Joule N Stevenson MD LLC 12277 De Paul Dr Suite 406 Bridgeton MO 63044-2516 Ph: (314) 731-7844 |
| NPI Number | 1407068851 |
|---|---|
| Provider Enumeration Date | 05/05/2007 |
| Last Update Date | 05/02/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407068851 | NPI | - | NPPES |
| 40798V56535 | Other | MO | HEALTHCAREUSA |
| 507561801 | Medicaid | MO | |
| 165057 | Other | MO | BLUECROSSBLUESHIELD |
| 321634 | Other | MO | HARMONY HEALTH PLAN |
| 520762 | Other | MO | HEALTHLINK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 2002019263 (Missouri) | Primary |
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