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Individual

TIM PROPECK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
300 FIRST CAPITOL DRIVE, ST CHARLES, MO 63301
(636) 947-5444
Mailing address
220 COMPASS POINT DR, SAINT CHARLES, MO 63301-4405
(636) 947-4480

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2000151559
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00280646
RAILROAD MEDICARE
MO
Enumeration date
07/19/2006
Last updated
07/08/2007
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