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Individual

DR. JAY P MULLIGAN JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
11872 GRAVOIS RD, SAINT LOUIS, MO 63127-1800
(314) 849-3040
(314) 849-7279
Mailing address
11872 GRAVOIS RD, SAINT LOUIS, MO 63127-1800
(314) 849-3040
(314) 849-7279

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
005086
MO
111N00000X
Chiropractor
1550
NC
111N00000X
Chiropractor
5684
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000010306
ESSENCE HEALTHCARE
01
1329576
PRINCIPAL HEALTH CARE
01
140968
GHP
MO
01
177379
HEALTHLINK PPO
01
250010
ASHN
MO
01
250888
ACN
MO
01
3082849
CIGNA
01
350057134
RAILROAD MEDICARE
MO
01
4218073
AETNA
01
4400465
MEDICARE COMPLETE
01
5086
ALL
01
5224
BCBS ALLIANCE
Enumeration date
09/07/2005
Last updated
04/15/2008
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