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General NPI Number Information
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NPI Number | 1760502207
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Entity Type | Individual
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Provider Name | JAMES MIKOLAJCZAK M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 141 N MERAMEC AVE
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City | CLAYTON
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State | MO
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Zip | 63105-3750
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Country | US
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Telephone | 314-726-1666
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Fax |
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Provider Business Mailing Address
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Address Line | 141 N MERAMEC AVE
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City | CLAYTON
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State | MO
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Zip | 63105-3750
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Country | US
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Telephone |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 34665
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 34665
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number | 34665
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License Number State | MO
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