Individual
DR. JEFFREY JIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4921 PARKVIEW PL STE 8A, STE 8A, SAINT LOUIS, MO 63110-1032
(314) 362-6519
(314) 362-4615
Mailing address
660 S EUCLID AVE, C B 8109, SAINT LOUIS, MO 63110-1010
(314) 362-6519
(314) 362-4615
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
2010015658
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568602886
—
MO
05
—
ENROLLED
—
IL
Enumeration date
02/26/2009
Last updated
01/24/2018
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