MEDICARE: VALLERIE JAIN 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	207R00000X	Internal Medicine Physician	W0187	TX

General Provider Information

NPI Number	:	1861027443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALLERIE JAIN MD

Provider Business Mailing Address
First Line	:	PO BOX 3891
Second Line	:
City	:	CHESTERFIELD
State	:	MO
Zip	:	63006-3891
Country	:	US
Telephone Number	:	636-933-2243
Fax Number	:

Provider Business Practice Location Address
First Line	:	1405 N TRUMAN BLVD
Second Line	:
City	:	FESTUS
State	:	MO
Zip	:	63028-1177
Country	:	US
Telephone Number	:	636-933-2243
Fax Number	:

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

Provider Enumeration Date	:	03/04/2020
Last Update Date	:	12/24/2025

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