MEDICARE: DR. BRETT WILLIAM JAGGER MD

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	207RI0200X	Infectious Disease Physician	2023000978	MO

General Provider Information

NPI Number	:	1730528035
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRETT WILLIAM JAGGER MD

Provider Business Mailing Address
First Line	:	1008 S SPRING AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-2520
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1225 S GRAND BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63104-1016
Country	:	US
Telephone Number	:	314-977-9050
Fax Number	:

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

Provider Enumeration Date	:	06/19/2013
Last Update Date	:	12/22/2025

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