Individual
DR. JASON THOMAS MAYNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD/PHD
Contact information
Practice address
1 CHILDRENS PL # 3S34, SAINT LOUIS, MO 63110-1002
(314) 454-6006
(314) 454-4102
Mailing address
660 S EUCLID AVE # 8033, SAINT LOUIS, MO 63110-1010
(314) 747-4479
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
2006024353
MO
208000000X
Pediatrics Physician
Primary
2006024353
MO
Other
Enumeration date
01/18/2008
Last updated
07/01/2008
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