Healthcare Provider Details

I. General information

NPI: 1962414227
Provider Name (Legal Business Name): JOE D BEHRMANN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 10/25/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1034 S. BRENTWOOD BLVD. SUITE 516
ST. LOUIS MO
63117
US

IV. Provider business mailing address

1034 S. BRENTWOOD BLVD. SUITE 516
ST. LOUIS MO
63117
US

V. Phone/Fax

Practice location:
  • Phone: 314-230-4490
  • Fax: 314-453-3477
Mailing address:
  • Phone: 314-230-4490
  • Fax: 314-453-3477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2004008629
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: