Individual
DR. JAMES LEE BOCKHORST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1177 E CHERRY ST, TROY, MO 63379-1520
(636) 528-1919
(636) 528-1916
Mailing address
176 GORGET DR, TROY, MO 63379-2538
(636) 528-2321
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
221366
MO
208000000X
Pediatrics Physician
077577
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208774109
—
MO
Enumeration date
09/12/2005
Last updated
02/05/2015
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