Healthcare Provider Details

I. General information

NPI: 1205908639
Provider Name (Legal Business Name): BARRY F ZEFFREN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8150 AMHERST AVE
SAINT LOUIS MO
63130-3605
US

IV. Provider business mailing address

4 COUNTRY CLUB EXECUTIVE PARK
GLEN CARBON IL
62034-1702
US

V. Phone/Fax

Practice location:
  • Phone: 773-260-0964
  • Fax:
Mailing address:
  • Phone: 618-288-6673
  • Fax: 618-288-1938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberR8A32
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number036068207
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: