Individual
DR. JEFFREY J HALLAZGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
714 GRAVOIS RD, SUITE 100, FENTON, MO 63026-7723
(636) 326-6100
(636) 326-6110
Mailing address
12680 OLIVE BLVD STE 100, CREVE COEUR, MO 63141-6322
(314) 251-8900
(314) 251-8901
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R4G27
MO
Other
Enumeration date
07/13/2006
Last updated
05/10/2021
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