Individual
JAY NOFFSINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5369
(314) 577-5379
Mailing address
3691 RUTGER ST, PROVIDER ENROLLMENT, SAINT LOUIS, MO 63110-2515
(314) 977-6828
(314) 977-6777
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
R2J74
MO
208000000X
Pediatrics Physician
Primary
R2J74
MO
2080S0010X
Pediatric Sports Medicine Physician
R2J74
MO
Other
Enumeration date
07/21/2006
Last updated
07/12/2007
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