Healthcare Provider Details

I. General information

NPI: 1952853889
Provider Name (Legal Business Name): TOTAL ACCESS URGENT CARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2016
Last Update Date: 07/28/2024
Certification Date: 07/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 HIGHWAY K
O'FALLON MO
63368-8230
US

IV. Provider business mailing address

9556 MANCHESTER RD
SAINT LOUIS MO
63119-1313
US

V. Phone/Fax

Practice location:
  • Phone: 314-961-2255
  • Fax: 314-270-3694
Mailing address:
  • Phone: 314-961-2255
  • Fax: 314-270-3694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number2005029371
License Number StateMO

VIII. Authorized Official

Name: TROY ADAM DINKEL
Title or Position: OWNER
Credential: MD
Phone: 314-961-2255