Healthcare Provider Details

I. General information

NPI: 1720567480
Provider Name (Legal Business Name): D TROY CURRY MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2018
Last Update Date: 08/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11477 OLDE CABIN RD STE 210
CREVE COEUR MO
63141-7129
US

IV. Provider business mailing address

11477 OLDE CABIN RD STE 210
CREVE COEUR MO
63141-7129
US

V. Phone/Fax

Practice location:
  • Phone: 314-997-5208
  • Fax: 636-997-5368
Mailing address:
  • Phone: 314-997-5208
  • Fax: 636-997-5368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberR3M26
License Number StateMO

VIII. Authorized Official

Name: D TROY CURRY
Title or Position: OWNER
Credential: MD
Phone: 314-997-5208