Healthcare Provider Details

I. General information

NPI: 1154355261
Provider Name (Legal Business Name): JULIE ELIZABETH HINKLE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JULIE ELIZABETH KUNKEL MD

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 02/06/2024
Certification Date: 02/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 S. NEW BALLAS RD
ST. LOUIS MO
63141
US

IV. Provider business mailing address

PO BOX 20452
COLUMBUS OH
43220-0452
US

V. Phone/Fax

Practice location:
  • Phone: 314-251-6000
  • Fax:
Mailing address:
  • Phone: 614-457-8180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number2008013749
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number2006015937
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: