Provider Demographics
NPI:1801357967
Name:BEHRENS, JOSEPH ROBERT (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ROBERT
Last Name:BEHRENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1400 US HIGHWAY 61 STE 310
Mailing Address - Street 2:
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-4141
Mailing Address - Country:US
Mailing Address - Phone:636-543-2140
Mailing Address - Fax:636-933-1085
Practice Address - Street 1:1400 US HIGHWAY 61 STE 310
Practice Address - Street 2:
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-4141
Practice Address - Country:US
Practice Address - Phone:636-543-2140
Practice Address - Fax:636-933-1085
Is Sole Proprietor?:No
Enumeration Date:2019-03-29
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024018588208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery