John Rabun, MD, LLC
Exclusive Provider Organization in Saint Louis, MO. Organization (NPI-2).
NPI number1225314248
StatusActive
Last updated in NPPESOct 24, 2011
Details
- NPI
- 1225314248
- Entity type
- Organization (NPI-2)
- Legal business name
- John Rabun, MD, LLC
- Organization subpart
- No
- Enumeration date
- Oct 24, 2011
- Last updated
- Oct 24, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 302F00000X | Exclusive Provider Organization | R8N45 | MO | Yes |
Practice location
9890 Clayton RdSaint Louis, MO 63124-1685
Phone 314-251-7720
Mailing address
6024 Southland AveSaint Louis, MO 63109-3659
Authorized official
John Rabun
Psychiatrist
3142517720
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