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Jose Javier Derdoy, MD
Pediatric Gastroenterology Physician in Saint Louis, Missouri
NPI 1396838876

Jose Javier Derdoy is a Pediatric Gastroenterology Physician based in Saint Louis, MO and is specialized in Pediatric Gastroenterology. Jose Javier Derdoy practices in Saint Louis, MO and has the professional credentials of MD. The NPI Number for Jose Javier Derdoy is 1396838876 and holds a License No. 60035 (Missouri).

The current practice location address for Jose Javier Derdoy is 615 S New Ballas Rd, Saint Louis, MO and can be reached out via phone at 314-251-5550 and via fax at 314-251-5552.

Location: 615 S New Ballas Rd, Saint Louis, MO, 63141-8221
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Provider Profile Details
NPI Number
1396838876
Provider Name
Jose Javier Derdoy
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
615 S New Ballas Rd, Saint Louis, MO, 63141-8221
Phone Number
314-251-5550
Fax Number
314-251-5552
Provider Enumeration Date
10/02/2006
Last Update Date
10/19/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1396838876 05 MO
00A730200 05 CA
300096168 05 IN
institution
Provider Business Practice Location Address Details
Address
615 S New Ballas Rd
City
State
Zip
63141-8221
Phone Number
314-251-5550
Fax Number
314-251-5552
person
Provider Business Mailing Address Details
Address
615 S New Ballas Rd
City
State
Zip
63141-8221
Phone Number
314-251-5550
Fax Number
314-251-5552
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
License No.
430654872 (Missouri)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Pediatrics
Speciality
Pediatric Gastroenterology
Taxonomy
License No.
60035 (Kentucky)
Definition
A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs.
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