Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 2006004093 | MO |
NPI | 1265663348 |
---|---|
Provider Name | Dr. John F Medler |
First Address | Saint Albans, MO 63073-0288 |
Second Address | Saint Albans, MO 63073-0288 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2009 |
Last Update Date | 06/08/2009 |