Individual
JIM CLARK SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
12 JEFFERSON SQ, DE SOTO, MO 63020-1031
(636) 586-6685
(636) 586-2780
Mailing address
12 JEFFERSON SQ, DE SOTO, MO 63020-1031
(636) 586-6685
(636) 586-2780
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2009024604
MO
207Q00000X
Family Medicine Physician
Primary
MD2799
AK
Other
Enumeration date
07/10/2006
Last updated
07/26/2010
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