Kuciejczyk-Kernan, Thomas Patrick

Kuciejczyk-Kernan, Thomas Patrick is an individual health care provider with primary practice located at 3930 S Broadway , Saint Louis MO 63118-4626. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Psychosomatic Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Kuciejczyk-Kernan, Thomas Patrick can be contacted via phone (314) 898-1700.

Contact Information

Primary practice address
3930 S Broadway Saint Louis MO 63118-4626
Phone: (314) 898-1700
Fax: (314) 814-8542
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X R6J90 Missouri
Allopathic & Osteopathic Physicians / Psychosomatic Medicine 2084P0015X R6J90 Missouri

Profile Details

NPI number 1669478970
LBN Legal business name Kuciejczyk-Kernan, Thomas Patrick
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2005
Last updated Sep 1st, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669478970 NPPES
Missouri MEDICAID 202710109

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