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Organization
MISSOURI RENAL MEDICINE
Active
Organization
MISSOURI RENAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBYN H JACOBS MD (PHYSICIAN)
(314) 251-6344
Entity
Organization
Contact information
Practice address
621 S NEW BALLAS RD, SUITE 3015B, SAINT LOUIS, MO 63141-8232
(314) 251-6344
(314) 251-7929
Mailing address
621 S NEW BALLAS RD, SUITE 3015B, SAINT LOUIS, MO 63141-8232
(314) 251-6344
(314) 251-7929
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
506877000
—
MO
01
—
CP8380
RAILROAD MEDICARE
MO
Enumeration date
05/22/2007
Last updated
05/03/2012
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