Individual
JORDAN TRACE PERKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1008 S SPRING AVE, SAINT LOUIS, MO 63110-2520
(314) 977-1642
(314) 977-1642
Mailing address
1402 S GRAND BLVD # M260, SAINT LOUIS, MO 63104-1004
(314) 977-1642
(314) 977-1642
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2021021646
MO
Other
Enumeration date
05/28/2019
Last updated
06/14/2021
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