Individual
DR. RONALD RICHARD JACKUPS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 BARNES JEWISH HOSPITAL PLZ, DIV PA LAB AND GENOMIC MED, SAINT LOUIS, MO 63110-1003
(314) 362-5641
(314) 362-0369
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 362-5641
(314) 362-0369
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
2012005897
MO
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
2012005897
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209529908
—
MO
Enumeration date
10/16/2008
Last updated
04/17/2025
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