Provider Demographics
NPI:1841303138
Name:JUNKER, JAMES A (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:JUNKER
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 1:11475 OLDE CABIN RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7129
Mailing Address - Country:US
Mailing Address - Phone:314-991-8200
Mailing Address - Fax:314-991-8210
Practice Address - Street 1:1400 US HIGHWAY 61
Practice Address - Street 2:
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028
Practice Address - Country:US
Practice Address - Phone:636-933-1059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR5A432085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO201411717Medicaid
4898V12822OtherHEALTHCARE USA
122542OtherHEALTHLINK
MO201411717Medicaid
MO27716OtherGROUP HEALTH PLAN
MO194361OtherBLUE SHIELD
1600012OtherMEDICARE COMPLETE
MO300015826OtherRAILROAD MEDICARE
3848OtherCMR
3848OtherCMR CARPENTERS
A12091OtherMERCY HEALTH PLAN
MO003010084Medicare ID - Type Unspecified
MO300015826OtherRAILROAD MEDICARE