Provider Demographics
NPI:1558378216
Name:JACHNA, CAROLYN M (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:M
Last Name:JACHNA
Suffix:
Gender:F
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:314-454-7775
Mailing Address - Fax:314-996-3087
Practice Address - Street 1:10 BARNES WEST DR
Practice Address - Street 2:DIV IM BONE AND MINERAL, STE 200
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6287
Practice Address - Country:US
Practice Address - Phone:314-454-7775
Practice Address - Fax:314-996-3087
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2024-04-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2005020837207RE0101X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205328016Medicaid
ILENROLLEDMedicaid