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Individual

RANDY S. SPRAGUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3660 VISTA AVE, SAINT LOUIS, MO 63110-2540
(314) 577-6095
(314) 577-6121
Mailing address
3691 RUTGER ST, PROVIDER ENROLLMENT, SAINT LOUIS, MO 63110-2515
(314) 977-6828
(314) 977-6777

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R7946
MO
208U00000X
Clinical Pharmacology Physician
Primary
R7946
MO

Other

Enumeration date
08/14/2006
Last updated
09/11/2025
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