Provider Demographics
NPI:1164429676
Name:ST. LOUIS, JOSEPH A JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:ST. LOUIS
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:5901 PEACHTREE DUNWOODY RD NE
Mailing Address - Street 2:SUITE C-370
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5382
Mailing Address - Country:US
Mailing Address - Phone:678-892-2020
Mailing Address - Fax:678-538-1950
Practice Address - Street 1:5671 PEACHTREE DUNWOODY RD NE
Practice Address - Street 2:SUITE 400
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-5000
Practice Address - Country:US
Practice Address - Phone:404-256-1507
Practice Address - Fax:404-256-1981
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2007-12-17
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Provider Licenses
StateLicense IDTaxonomies
GA010675207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA589554OtherBCBS
GA0808267OtherUHC
GA294532OtherWELLCARE
GA4266009OtherAETNA
GA501899OtherAETNA HMO
GA00062433BMedicaid
GA693018OtherBCBS
GA00062433DMedicaid
GA03625OtherCOVENTRY PPO
GA1407OtherCOVENTRY HMO
GA294532OtherWELLCARE
GAE58725Medicare UPIN
1078920002Medicare NSC
GA501899OtherAETNA HMO