Individual
JAY L. PADRATZIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
621 S NEW BALLAS RD, SUITE 4017-B, SAINT LOUIS, MO 63141-8232
(314) 872-9192
(314) 995-4234
Mailing address
621 S NEW BALLAS RD, SUITE 4017-B, SAINT LOUIS, MO 63141-8232
(314) 872-9192
(314) 995-4234
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
119455
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467427161
—
MO
01
—
160049273
RAILROAD MEDICARE
MO
01
—
160052306
RAILROAD MEDICARE
MO
Enumeration date
02/17/2006
Last updated
07/14/2014
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