Provider Demographics
NPI:1063674513
Name:WEBER, JULIE PHILLIPS (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:PHILLIPS
Last Name:WEBER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:PHILLIPS
Other - Last Name:LORBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1390 US HIGHWAY 61
Mailing Address - Street 2:STE G1500
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-4137
Mailing Address - Country:US
Mailing Address - Phone:636-933-1163
Mailing Address - Fax:636-933-5789
Practice Address - Street 1:1390 US HIGHWAY 61
Practice Address - Street 2:STE G1500
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-4137
Practice Address - Country:US
Practice Address - Phone:636-933-1163
Practice Address - Fax:636-933-5789
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036125132208600000X
MO2011012294208600000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery