Individual
VINCENT Q JOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3015 N BALLAS RD, SAINT LOUIS, MO 63131-2329
(314) 996-5157
(314) 996-4398
Mailing address
3015 N BALLAS RD, SAINT LOUIS, MO 63131
(314) 996-5157
(314) 996-4398
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
036109465
IL
2085R0001X
Radiation Oncology Physician
Primary
2000157004
MO
2085R0202X
Diagnostic Radiology Physician
036109465
IL
2085R0202X
Diagnostic Radiology Physician
2000157004
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0361094651
—
IL
01
—
1390
MO BLUE
—
01
—
143115
BLUE CHOICE
—
05
—
205073109
—
MO
01
—
2400026
PH PLAN
—
01
—
2781
GHP
—
01
—
431725842MID
MERCY
—
01
—
46055
HCARE USA
—
01
—
468378
HLINK
—
01
—
920006052
RR MEDICARE
—
Enumeration date
07/31/2006
Last updated
10/29/2021
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