Healthcare Provider Details

I. General information

NPI: 1952451999
Provider Name (Legal Business Name): PHINEAS PHILLIP OREN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 HITT ST
COLUMBIA MO
65212-0001
US

IV. Provider business mailing address

621 S NEW BALLAS RD SUITE: 6009-B
SAINT LOUIS MO
63141-8232
US

V. Phone/Fax

Practice location:
  • Phone: 573-882-2272
  • Fax: 573-884-5179
Mailing address:
  • Phone: 314-251-6299
  • Fax: 314-251-4450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2008022582
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number2008022582
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: