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NPI Code Detail

MEDICARE: DR. LINDA J ALGRA M.D.

MEDICARE: DR. LINDA J ALGRA M.D.
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
1207L00000XAnesthesiology Physician104912MO

General Provider Information

NPI Number : 1568467959
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LINDA J ALGRA M.D.
Provider Business Mailing Address
First Line : 339 CONSORT DR
Second Line :
City : BALLWIN
State : MO
Zip : 63011-4439
Country : US
Telephone Number : 636-386-9224
Fax Number : 636-386-7679
Provider Business Practice Location Address
First Line : 615 S NEW BALLAS RD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63141-8221
Country : US
Telephone Number : 636-386-9224
Fax Number : 636-386-7679
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2005
Last Update Date : 10/30/2007

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