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Individual

DR. JEREMY DANIEL DEFOE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
3009 N BALLAS RD STE 227A, SAINT LOUIS, MO 63131
(314) 996-7800
(314) 996-7829
Mailing address
3009 N BALLAS RD STE 227A, SAINT LOUIS, MO 63131-2308
(314) 996-7800
(314) 996-7829

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2018028875
MO
208M00000X
Hospitalist Physician
2018028875
MO

Other

Enumeration date
07/10/2012
Last updated
03/03/2021
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