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General NPI Number Information
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NPI Number | 1194468876
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Entity Type | Individual
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Provider Name | JAMES WENDELL DO
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Gender | Male
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Dates
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Enumeration Date | 04/19/2022
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 2630 STATE HIGHWAY K STE 100
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City | OFALLON
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State | MO
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Zip | 63368
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Country | US
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Telephone | 636-240-5454
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Fax | 636-980-5335
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Provider Business Mailing Address
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Address Line | PO BOX 959354
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City | SAINT LOUIS
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State | MO
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Zip | 63195-9354
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Country | US
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Telephone | 307-234-6161
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 206-T1
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2025029276
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License Number State | MO
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