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General NPI Number Information
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NPI Number | 1023502358
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Entity Type | Individual
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Provider Name | BRYAN GABRIEL ACREE DO
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Gender | Male
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Dates
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Enumeration Date | 06/20/2018
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 965 MATTOX DR
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City | SULLIVAN
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State | MO
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Zip | 63080-2365
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Country | US
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Telephone | 573-860-6000
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Fax | 573-860-6016
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Provider Business Mailing Address
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Address Line | PO BOX 959318
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City | SAINT LOUIS
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State | MO
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Zip | 63195-1664
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Country | US
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Telephone | 573-860-6000
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Fax | 573-860-6016
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2021000960
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License Number State | MO
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