Provider Demographics
NPI:1053392324
Name:SCHOEN, JAMES DOUGLAS (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:DOUGLAS
Last Name:SCHOEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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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:314-984-8827
Mailing Address - Fax:314-984-0736
Practice Address - Street 1:9930 WATSON RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63126-1827
Practice Address - Country:US
Practice Address - Phone:314-984-8827
Practice Address - Fax:314-984-0736
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20040096112085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO46279V3431OtherHEALTHCARE USA
MO000000010861OtherESSENCE
MO208991208Medicaid
MO221225OtherGHP
MO144352OtherBCBS
MO1603360OtherUHC
MO660879OtherHEALTHLINK
MO890124OtherMERCY CARE
MOI08804OtherMERCY
MO890124OtherMERCY CARE
MO221225OtherGHP
MO46279V3431OtherHEALTHCARE USA
MO918435405Medicare PIN
MO918435406Medicare UPIN