Individual
DR. JACK ROH OAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12266 DE PAUL DR STE 305, BRIDGETON, MO 63044-2514
(314) 770-0991
Mailing address
660 S EUCLID AVE, MSC 8109-05-04, SAINT LOUIS, MO 63110-1010
(314) 991-4644
(314) 991-4910
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
2003009197
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209363209
—
MO
Enumeration date
05/02/2007
Last updated
08/01/2023
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