Provider Demographics
NPI:1841272804
Name:SPEISER, JAMES (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:SPEISER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23340
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63156-3340
Mailing Address - Country:US
Mailing Address - Phone:314-849-6000
Mailing Address - Fax:314-849-1417
Practice Address - Street 1:12345 W BEND DR
Practice Address - Street 2:SUITE 300
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2182
Practice Address - Country:US
Practice Address - Phone:314-849-6000
Practice Address - Fax:314-849-1417
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR5A65207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0400009OtherUHC MEDICARE COMPLETE
MO0404109OtherUHC PCP
MO127521OtherGHP PCP
MOA10037OtherMERCY
MO105421OtherBCBS
MO165271OtherGHP RHEUMO SPEC
MO122951OtherHEALTHLINK
MO000000010037OtherESSENCE PCP
MO000000010714OtherESSENCE RHEUMA
MO3200009OtherUHC RHEUM SPEC
MO4135004OtherAETNA
MO3200009OtherUHC RHEUM SPEC
MO122951OtherHEALTHLINK
MO127521OtherGHP PCP