Healthcare Provider Details

I. General information

NPI: 1417861287
Provider Name (Legal Business Name): MR. ROBERT DOUGLAS MCKAY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 SALT RIVER RD
SAINT PETERS MO
63376-3956
US

IV. Provider business mailing address

1360 DARTMOUTH CT
SAINT CHARLES MO
63303-3658
US

V. Phone/Fax

Practice location:
  • Phone: 636-344-7600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License NumberP-21966
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: