Provider Demographics
NPI:1295937423
Name:ALLIED PHYSICIANS GROUP LLC
Entity type:Organization
Organization Name:ALLIED PHYSICIANS GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEURET
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:314-275-8737
Mailing Address - Street 1:PO BOX 790126
Mailing Address - Street 2:DEPT. 30705
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63179-0126
Mailing Address - Country:US
Mailing Address - Phone:314-275-8737
Mailing Address - Fax:
Practice Address - Street 1:244 E PRIMROSE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5206
Practice Address - Country:US
Practice Address - Phone:417-315-9602
Practice Address - Fax:636-600-5042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003006353111NR0400X
261QR0400X
MOMO100753174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1093872269OtherNPI
MO1477600641OtherNPI
MO1326105537OtherNPI
MO1174504161OtherNPI
MO1710037908OtherNPI
MO1730341496OtherNPI
MO1598822710OtherNPI
MO1679620850OtherNPI
MO1326105537OtherNPI