Individual
DR. JEFFREY A VANDER KOOI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16100 CHESTERFIELD PKWY W STE 260, CHESTERFIELD, MO 63017-4836
(636) 778-9427
(636) 778-9632
Mailing address
16100 CHESTERFIELD PKWY W STE 260, CHESTERFIELD, MO 63017-4836
(636) 778-9427
(636) 778-9632
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2004035420
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1588772487
GROUP NPI #
MO
Enumeration date
07/12/2006
Last updated
05/16/2024
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