Individual
FEDERICO J JIMENEZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2345 DOUGHERTY FERRY RD, SAINT LOUIS, MO 63122-3313
(314) 821-5850
Mailing address
2345 DOUGHERTY FERRY RD, SAINT LOUIS, MO 63122-3313
(314) 821-5850
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
35897
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201618121
—
MO
Enumeration date
06/22/2006
Last updated
04/11/2008
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