Individual
JOHN E VERNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12680 OLIVE BLVD STE 100, SAINT LOUIS, MO 63141-6322
(314) 251-8900
Mailing address
12680 OLIVE BLVD STE 100, SAINT LOUIS, MO 63141-6322
(314) 251-8900
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2001031156
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208988501
—
MO
Enumeration date
07/11/2005
Last updated
03/13/2018
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