Healthcare Provider Details

I. General information

NPI: 1588659288
Provider Name (Legal Business Name): DAVID LEE OHLMS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12166 OLD BIG BEND RD SUITE 100
KIRKWOOD MO
63122-6844
US

IV. Provider business mailing address

12166 OLD BIG BEND RD SUITE 100
KIRKWOOD MO
63122-6844
US

V. Phone/Fax

Practice location:
  • Phone: 314-909-0211
  • Fax: 314-909-0323
Mailing address:
  • Phone: 314-909-0211
  • Fax: 314-909-0323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMDR 3640
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberR3640
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: