Individual
DR. TIMOTHY J REICHERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
621 S NEW BALLAS RD, SUITE 622A, SAINT LOUIS, MO 63141-8232
(314) 872-8340
(314) 872-8399
Mailing address
621 S NEW BALLAS RD, SUITE 622A, SAINT LOUIS, MO 63141-8232
(314) 872-8340
(314) 872-8399
Taxonomy
Speciality
Code
Description
License number
State
207YP0228X
Pediatric Otolaryngology Physician
Primary
R7939
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200454916
—
MO
Enumeration date
04/17/2006
Last updated
05/04/2011
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