Provider Demographics
NPI:1265450720
Name:ATKINSON, JEFFREY J (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:J
Last Name:ATKINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
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:314-454-8917
Mailing Address - Fax:314-747-2200
Practice Address - Street 1:4921 PARKVIEW PL
Practice Address - Street 2:DIV IM PULMONARY AND CCM, 8TH FL
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1032
Practice Address - Country:US
Practice Address - Phone:314-454-8917
Practice Address - Fax:314-747-2200
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2001026567207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205706401Medicaid
ILENROLLEDMedicaid
MO015110183Medicare PIN
MO015110183Medicaid