Provider Demographics
NPI:1912935750
Name:TESSIER, JOHN E (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:TESSIER
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 1:675 OLD BALLAS RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7083
Mailing Address - Country:US
Mailing Address - Phone:314-733-9009
Mailing Address - Fax:
Practice Address - Street 1:675 OLD BALLAS RD STE 100
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-7083
Practice Address - Country:US
Practice Address - Phone:314-733-9009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO36318207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO21933OtherBLUE CROSS BLUE SHIELD
MO200042317OtherRAILROAD MEDICARE
MO0900105OtherUNITED HEALTHCARE
MO180466OtherHEALTHLINK
MO3154921001OtherCIGNA
MO83364V3223OtherGROUP HEALTHPLAN
MO202925400Medicaid
MO4294896OtherAETNA
A09741Medicare UPIN
MO83364V3223OtherGROUP HEALTHPLAN