Provider Demographics
NPI:1093733503
Name:SCHOENECKER, PERRY L (MD)
Entity Type:Individual
Prefix:DR
First Name:PERRY
Middle Name:L
Last Name:SCHOENECKER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 60352
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63160-0352
Mailing Address - Country:US
Mailing Address - Phone:314-454-6062
Mailing Address - Fax:314-454-5054
Practice Address - Street 1:1 CHILDRENS PL
Practice Address - Street 2:STE 1B
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1002
Practice Address - Country:US
Practice Address - Phone:314-454-6062
Practice Address - Fax:314-454-5054
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2024-04-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOR5001207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200653806Medicaid
MO200653806Medicaid
IL0560568077Medicaid
MO014010232Medicare PIN