MEDICARE: DR. DONN CRAIG KLEINSCHMIDT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	R2J62	MO

General Provider Information

NPI Number	:	1205975182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONN CRAIG KLEINSCHMIDT MD

Provider Business Mailing Address
First Line	:	4340 W PINE BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63108-2206
Country	:	US
Telephone Number	:	314-402-6845
Fax Number	:	314-442-4094

Provider Business Practice Location Address
First Line	:	4231 LACLEDE AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63108-2814
Country	:	US
Telephone Number	:	314-402-6845
Fax Number	:	314-442-4094

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	07/08/2007

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