Healthcare Provider Details

I. General information

NPI: 1427074657
Provider Name (Legal Business Name): GEORGE JOHN HAROCOPOS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 S EUCLID AVE
SAINT LOUIS MO
63110-1007
US

IV. Provider business mailing address

PO BOX 7412011
CHICAGO IL
60674-2011
US

V. Phone/Fax

Practice location:
  • Phone: 314-362-3431
  • Fax: 314-362-3725
Mailing address:
  • Phone: 314-362-3937
  • Fax: 314-362-3725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number2004009695
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number2004009695
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: