Provider Demographics
NPI:1356423982
Name:GERARD, JOSEPH HERBERT (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:HERBERT
Last Name:GERARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409B WARREN AVENUE
Mailing Address - Street 2:
Mailing Address - City:WRIGHT CITY
Mailing Address - State:MO
Mailing Address - Zip Code:63390
Mailing Address - Country:US
Mailing Address - Phone:636-745-7788
Mailing Address - Fax:636-745-7788
Practice Address - Street 1:409B WARREN AVENUE
Practice Address - Street 2:
Practice Address - City:WRIGHT CITY
Practice Address - State:MO
Practice Address - Zip Code:63390
Practice Address - Country:US
Practice Address - Phone:636-745-7788
Practice Address - Fax:636-745-7788
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO5823111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
4480841OtherUHC
144336OtherBCBS GHP