Healthcare Provider Details

I. General information

NPI: 1356823397
Provider Name (Legal Business Name): TOTAL ACCESS URGENT CARE P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2018
Last Update Date: 07/28/2024
Certification Date: 07/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2060 HAMPTON AVE
SAINT LOUIS MO
63139-2903
US

IV. Provider business mailing address

13861 MANCHESTER RD
BALLWIN MO
63011-4503
US

V. Phone/Fax

Practice location:
  • Phone: 314-696-2341
  • Fax:
Mailing address:
  • Phone: 636-556-0114
  • Fax: 314-270-3694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

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