Dr. Jason B Vangundy, M.D.
Family Medicine in Lake St Louis, MO. Individual provider (NPI-1).
NPI number1790746071
StatusActive
Last updated in NPPESNov 25, 2020
Details
- NPI
- 1790746071
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jason B Vangundy
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 28, 2006
- Certification date
- Nov 25, 2020
- Last updated
- Nov 25, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 2001012077 | MO | Yes |
Practice location
400 Medical Plz Ste 200Lake St Louis, MO 63367-1417
Phone 636-625-2662
Mailing address
Po Box 955534Saint Louis, MO 63195-5534
Other practice locations
300 Medical Plz
Lake St Louis, MO 63367-1481
Lake St Louis, MO 63367-1481
Phone 636-625-2662 · Fax 636-669-2401
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All 9 Family Medicine Physician providers in Lake St Louis · All 376 providers in Lake St Louis
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