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General NPI Number Information
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NPI Number | 1467559658
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Entity Type | Individual
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Provider Name | VICTOR M PACE M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 11/15/2024
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Provider Practice Location Address
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Address Line | 1315 AUBERT AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63113-1918
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Country | US
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Telephone | 314-449-9726
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Fax | 314-449-9641
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Provider Business Mailing Address
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Address Line | PO BOX 4046
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City | SPRINGFIELD
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State | MO
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Zip | 65808-4046
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Country | US
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Telephone | 417-269-2240
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Fax | 417-269-2245
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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 | 044301
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License Number State | GA
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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 | 118290
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License Number State | MO
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