Individual
DR. DAVID PAUL JAQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4921 PARKVIEW PL, STE 8C, SAINT LOUIS, MO 63110-1032
(314) 747-2938
(314) 367-1943
Mailing address
660 S EUCLID AVE, C B 8109, SAINT LOUIS, MO 63110-1010
(314) 747-2938
(314) 367-1943
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2007012289
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093706541
—
MO
Enumeration date
11/03/2005
Last updated
11/14/2016
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