MEDICARE: DR. JOSEPH A. ST. LOUIS JR. M.D.

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	010675	GA

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	589554	OTHER	GA	BCBS
2	0808267	OTHER	GA	UHC
3	294532	OTHER	GA	WELLCARE
4	4266009	OTHER	GA	AETNA
5	501899	OTHER	GA	AETNA HMO
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	693018	OTHER	GA	BCBS
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	03625	OTHER	GA	COVENTRY PPO
10	1407	OTHER	GA	COVENTRY HMO

NPI Number	:	1164429676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH A. ST. LOUIS JR. M.D.

Provider Business Mailing Address
First Line	:	5901 PEACHTREE DUNWOODY RD NE
Second Line	:	SUITE C-370
City	:	ATLANTA
State	:	GA
Zip	:	30328-5382
Country	:	US
Telephone Number	:	678-892-2020
Fax Number	:	678-538-1950

Provider Business Practice Location Address
First Line	:	5671 PEACHTREE DUNWOODY RD NE
Second Line	:	SUITE 400
City	:	ATLANTA
State	:	GA
Zip	:	30342-5000
Country	:	US
Telephone Number	:	404-256-1507
Fax Number	:	404-256-1981

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	12/17/2007

5671 PEACHTREE DUNWOODY RD NE , SUITE 515
ATLANTA, GA
30342-5000

Practice Phone: 404-531-0334
Practice Fax: 404-531-0494

5671 PEACHTREE DUNWOODY RD NE , SUITE 900
ATLANTA, GA
30342-5000