Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NI0013X | Independent Medical Examiner | 038.011843 | IL |
Y | 111NI0013X | Independent Medical Examiner | 2011001253 | MO |
NPI | 1013246214 |
---|---|
Provider Name | Dr. Jon Robert Pinkston |
First Address | Chesterfield, MO 63017-4807 |
Second Address | Chesterfield, MO 63017-4807 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2009 |
Last Update Date | 18/01/2011 |