Organization
KEVIN L. THRELKELD, M.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN L THRELKELD MD (PHYSICIAN REGISTERED AGENT)
(636) 390-1854
Entity
Organization
Contact information
Practice address
204 N MAIN ST, O FALLON, MO 63366-2203
(636) 240-3420
Mailing address
PO BOX 270003, SAINT LOUIS, MO 63127-0003
(636) 390-1854
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MDR5P58
MO
Other
Enumeration date
11/01/2006
Last updated
10/10/2019
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