Individual
DR. JOHN M MAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 N 8TH ST STE 120, EAST SAINT LOUIS, IL 62201-2989
(618) 337-2597
(618) 337-2930
Mailing address
100 N 8TH ST STE 120, EAST SAINT LOUIS, IL 62201-2989
(618) 337-2597
(618) 337-2930
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036096177
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036096177
MEDICAL LICENSE #
IL
Enumeration date
08/19/2006
Last updated
08/24/2023
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