MEDICARE: TOTAL ACCESS URGENT CARE, PC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000015584	OTHER		PTAN

General Provider Information

NPI Number	:	1245714849
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL ACCESS URGENT CARE, PC

Provider Business Mailing Address
First Line	:	13861 MANCHESTER RD
Second Line	:
City	:	BALLWIN
State	:	MO
Zip	:	63011-4503
Country	:	US
Telephone Number	:	636-556-0114
Fax Number	:	314-270-3694

Provider Business Practice Location Address
First Line	:	1005 S BIG BEND BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63117-1605
Country	:	US
Telephone Number	:	314-449-8677
Fax Number	:	314-449-8678

Authorized Official
Title or Position	:	OWNER
Name	:	TROY ADAM DINKEL
Credential	:	MD
Telephone Number	:	636-556-0114

Provider Enumeration Date	:	09/19/2018
Last Update Date	:	08/20/2024

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