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Individual

DR. JOHN ALAN VELLINGA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
4800 MEXICO RD, SUITE 101, SAINT PETERS, MO 63376-1666
(636) 936-0400
(636) 936-2252
Mailing address
4800 MEXICO RD, SUITE 101, SAINT PETERS, MO 63376-1666
(636) 936-0400
(636) 936-2252

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
R5P16
MO
208VP0000X
Pain Medicine Physician
Primary
R5P16
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
050055140
MEDICARE RAILROAD
MO
01
072246
FMH/EXCLUSIVE CHOICE
MO
01
197791
BCBS
MO
01
2000224
PHP
MO
05
246938112
MO
01
249776
HEALTHLINK
MO
01
35554
GHP
MO
01
431711815
NALC
MO
01
491711815
1ST HEALTH
MO
01
5339096
AETNA
MO
01
63868010001
CIGNA
MO
01
A003431711815
TRICARE
MO
01
F04439
MERCY
MO
Enumeration date
06/08/2006
Last updated
05/09/2012
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