Randy S. Sprague M.D.

NPI 1649283623 - Internal Medicine - 207R00000X

NPI Details
NPI 1649283623
Gender Male
Enumeration Date 08/14/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
3660 VISTA AVE
SAINT LOUIS MO, 63110-2540, US
Phone (314) 577-6095
Fax (314) 577-6121
Business Location
3691 RUTGER ST
PROVIDER ENROLLMENT
SAINT LOUIS MO, 63110-2515, US
Phone (314) 977-6828
Fax (314) 977-6777
Toxanomy
Taxonomy Code 207R00000X
License State Missouri
License Number R7946
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According to our database, Randy S. Sprague M.D. NPI is 1649283623, taxonomy code is 207R00000X and license number is R7946, license state is located at Missouri. Randy S. Sprague M.D. physically located at 3660 Vista Ave, Saint Louis MO, 63110-2540. NPI Number Randy S. Sprague M.D. has the Individual type.

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1649283623 NPI number is provided on an as is basis without warranty of any kind. 1649283623 is maintained by the National Plan & Provider Enumeration System. The contents of Randy S. Sprague M.D. are for informational purposes only.