# DOCTOR'S CLINICAL GROUP

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

## Provider details

- **NPI number:** 1871762385
- **Authorized official:** ROBERT P. POETZ D.O. (OWNER)
- **Authorized official phone:** (314) 291-0505

## Contact information

- **Practice address:** 12255 DEPAUL DRIVE SUITE 865, BRIDGETON, MO 63044
- **Practice address phone:** (314) 291-0505
- **Practice address fax:** (314) 291-0747
- **Mailing address:** PO BOX 790379, SAINT LOUIS, MO 63179-0379
- **Mailing address phone:** (314) 291-0505
- **Mailing address fax:** (314) 291-0747

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 29351 | MO | Yes |
| 363L00000X | Nurse Practitioner | 152467 | MO | — |

## Other

- **Enumeration date:** 02/28/2008
- **Last updated:** 05/22/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0004255603 | AETNA | MO |
| 01 | — | 01-00207 | UNITED HEALTH CARE | MO |
| 01 | — | 080130617 | MEDICARE RAILROAD | MO |
| 01 | — | 100805 | BC/BS | MO |
| 01 | — | 1013577 | CARE PARTNERS | MO |
| 01 | — | 103753 | HEALTHLINK | MO |
| 01 | — | 123036 | GHP | MO |
| 01 | — | 1940001 | PARTNERS | MO |
| 01 | — | 2064 | HEALTHCARE USA | MO |
| 05 | — | 240407908 | — | MO |
| 01 | — | 250759 | HARMONY | MO |
| 01 | — | 3065209001 | CIGNA | MO |
| 01 | — | 489409703 | MERCYCARE PLUS | MO |
| 01 | — | 77072 | WELLCARE | MO |
| 01 | — | D92011 | EXCLUSIVE CHOICE | MO |