Healthcare Provider Details

I. General information

NPI: 1578501011
Provider Name (Legal Business Name): KURT MORSE JAEGER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 12/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660A S TRUMAN BLVD
FESTUS MO
63028-2235
US

IV. Provider business mailing address

660A S TRUMAN BLVD
FESTUS MO
63028-2235
US

V. Phone/Fax

Practice location:
  • Phone: 636-931-3800
  • Fax: 636-931-3911
Mailing address:
  • Phone: 636-931-3800
  • Fax: 636-931-3911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License NumberG87569
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number112558
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: