Provider Demographics
NPI:1801967773
Name:DROEGE, WILLIAM J (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:DROEGE
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 1:1201 S BIG BEND BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-1645
Mailing Address - Country:US
Mailing Address - Phone:314-644-0885
Mailing Address - Fax:314-644-5836
Practice Address - Street 1:1201 S BIG BEND BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1645
Practice Address - Country:US
Practice Address - Phone:314-644-0885
Practice Address - Fax:314-644-5836
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOCE004302111N00000X
MO004302111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOT80974Medicare UPIN