Provider Demographics
NPI:1245218106
Name:PARTIN, JULIA (DPM)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:
Last Name:PARTIN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3009 N BALLAS RD STE 251C
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2352
Mailing Address - Country:US
Mailing Address - Phone:314-996-3690
Mailing Address - Fax:
Practice Address - Street 1:3009 N BALLAS RD STE 251C
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2352
Practice Address - Country:US
Practice Address - Phone:314-996-3690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-02
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003010842213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO308984418Medicaid
2700505OtherUHC
46302OtherHEALTHCARE USA
MO180300OtherBLUE CROSS BLUE SHIELD
202141604OtherBEECH STREET
2136783OtherFIRST HEALTH
MOP00233244OtherRR MEDICARE
202141604OtherPHCS
232125OtherGHP
MO308984426Medicaid
202141604OtherGREAT WEST
460737OtherHEALTHLINK
7837468OtherAETNA
202141604OtherMULTI PLAN
MO308984434Medicaid
U95106OtherMERCY
2700505OtherUHC
MO308984434Medicaid
MO001014527Medicare ID - Type UnspecifiedEUREKA MCR #