Healthcare Provider Details

I. General information

NPI: 1295703072
Provider Name (Legal Business Name): RICHARD E PARCINSKI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 N CLOVERLEAF DR STE G
SAINT PETERS MO
63376-6436
US

IV. Provider business mailing address

4200 N CLOVERLEAF DR STE G
SAINT PETERS MO
63376-6436
US

V. Phone/Fax

Practice location:
  • Phone: 636-936-1809
  • Fax: 636-936-3655
Mailing address:
  • Phone: 636-936-1809
  • Fax: 636-936-3655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number100526
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number100526
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: