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Organization

DOCTOR'S CLINICAL GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROBERT P. POETZ D.O. (OWNER)
(314) 291-0505
Entity
Organization

Contact information

Practice address
12255 DEPAUL DRIVE SUITE 865, BRIDGETON, MO 63044
(314) 291-0505
(314) 291-0747
Mailing address
PO BOX 790379, SAINT LOUIS, MO 63179-0379
(314) 291-0505
(314) 291-0747

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29351
MO
363L00000X
Nurse Practitioner
152467
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0004255603
AETNA
MO
01
01-00207
UNITED HEALTH CARE
MO
01
080130617
MEDICARE RAILROAD
MO
01
100805
ANTHEM BC/BS
MO
01
1013577
CARE PARTNERS
MO
01
103753
HEALTHLINK
MO
01
123036
GHP
MO
01
1940001
PARTNERS
MO
01
2064
HEALTHCARE USA
MO
05
240407908
MO
01
250759
HARMONY
MO
01
3065209001
CIGNA
MO
01
489409703
MERCYCARE PLUS
MO
01
77072
WELLCARE
MO
01
D92011
HUMANA
MO
Enumeration date
02/28/2008
Last updated
05/22/2008
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