Organization Name: | NEIL I. BRICKEL, MD, INC |
NPI Number: | 1215103643 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MOLLY I KENNEDY (MANAGER) |
Mailing Address: | 11477 Olde Cabin Rd Suite 210 Saint Louis |
State: | MO US |
Postal Code: | 631417130 |
Phone Number: | 3149975208 |
Fax Number: | 3149975368 |
NPI Enumeration Date: | 05/06/2008 |
NPI Last Update Date: | 10/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 31040 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |