Provider Demographics
NPI:1932618394
Name:UNITED PHYSICIANS GROUP
Entity Type:Organization
Organization Name:UNITED PHYSICIANS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:B
Authorized Official - Last Name:SCHRANCK
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:314-336-2570
Mailing Address - Street 1:14825 N OUTER 40 RD STE 365
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-2152
Mailing Address - Country:US
Mailing Address - Phone:314-392-5029
Mailing Address - Fax:314-392-5086
Practice Address - Street 1:14825 N OUTER 40 RD STE 365
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-2152
Practice Address - Country:US
Practice Address - Phone:314-496-4255
Practice Address - Fax:314-392-5086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-28
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty