Healthcare Provider Details

I. General information

NPI: 1962684886
Provider Name (Legal Business Name): TOTAL ACCESS URGENT CARE P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2007
Last Update Date: 07/28/2024
Certification Date: 07/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9556 MANCHESTER RD
SAINT LOUIS MO
63119-1313
US

IV. Provider business mailing address

13861 MANCHESTER RD
BALLWIN MO
63011-4503
US

V. Phone/Fax

Practice location:
  • Phone: 314-961-2255
  • Fax: 314-373-5757
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 Number2005029371
License Number StateMO

VIII. Authorized Official

Name: DR. TROY A DINKEL
Title or Position: OWNER
Credential: MD
Phone: 314-961-2255