Healthcare Provider Details

I. General information

NPI: 1639174691
Provider Name (Legal Business Name): ALEX J GAFFORD D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

745 CRAIG RD SUITE 301
SAINT LOUIS MO
63141-7122
US

IV. Provider business mailing address

12117 LADUE HEIGHTS DR
SAINT LOUIS MO
63141-6656
US

V. Phone/Fax

Practice location:
  • Phone: 314-275-7802
  • Fax:
Mailing address:
  • Phone: 314-275-7802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number2004013906
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2004013906
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: