# KIRK E. BROCKMAN M.D. DBA ST. CLAIR MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659428050
- **Authorized official:** DR. KIRK EDWARD BROCKMAN M.D. (OWNER)
- **Authorized official phone:** (636) 629-3300

## Contact information

- **Practice address:** 370 N COMMERCIAL AVE, SAINT CLAIR, MO 63077-1305
- **Practice address phone:** (636) 629-3300
- **Practice address fax:** (636) 629-7377
- **Mailing address:** 370 N COMMERCIAL AVE, SAINT CLAIR, MO 63077-1305
- **Mailing address phone:** (636) 629-3300
- **Mailing address fax:** (636) 629-7377

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | R2F53 | MO | Yes |

## Other

- **Enumeration date:** 01/05/2007
- **Last updated:** 06/16/2008