| Norman J. Ehlinger Jr D.o. Family Practice | |
|
3394 Mckelvey Rd Suite 104 Bridgeton MO 63044-2531 | |
| (314) 739-5518 | |
| (314) 739-1223 |
| Full Name | Norman J. Ehlinger Jr D.o. Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 3394 Mckelvey Rd, Bridgeton, Missouri |
| Authorized Official Name and Position | Thomas Edward Shepherd (MANAGING MEMBER) |
| Authorized Official Contact | 3147395518 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Norman J. Ehlinger Jr D.o. Family Practice 3394 Mckelvey Rd Suite 104 Bridgeton MO 63044-2531 Ph: (314) 739-5518 | Norman J. Ehlinger Jr D.o. Family Practice 3394 Mckelvey Rd Suite 104 Bridgeton MO 63044-2531 Ph: (314) 739-5518 |
| NPI Number | 1598926917 |
|---|---|
| Provider Enumeration Date | 06/18/2008 |
| Last Update Date | 02/07/2013 |
| Medicare PECOS PAC ID | 5395812952 |
|---|---|
| Medicare Enrollment ID | O20080923000675 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598926917 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Robert B Smith |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982687059 PECOS PAC ID: 4688583149 Enrollment ID: I20040303001131 |
| Provider Name | So Youn Kim-shepherd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831148469 PECOS PAC ID: 4587616149 Enrollment ID: I20050211000609 |
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