person
Mr. Jerry M Liddell, DPM
Foot & Ankle Surgery Podiatrist in Saint Louis, Missouri
NPI 1700872611

Jerry M Liddell is a Foot & Ankle Surgery Podiatrist based in Saint Louis, MO and is specialized in Foot & Ankle Surgery. Jerry M Liddell practices in Saint Louis, MO and has the professional credentials of DPM. The NPI Number for Jerry M Liddell is 1700872611 and holds a License No. 2005018735 (Missouri).

The current practice location address for Jerry M Liddell is 4901 Forest Park Ave, Saint Louis, MO and can be reached out via phone at 314-747-4769 and via fax at 888-824-2176.

Location: 4901 Forest Park Ave, Saint Louis, MO, 63160-0352
person
Provider Profile Details
NPI Number
1700872611
Provider Name
Jerry M Liddell
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
4901 Forest Park Ave, Saint Louis, MO, 63160-0352
Phone Number
314-747-4769
Fax Number
888-824-2176
Provider Enumeration Date
09/26/2005
Last Update Date
05/18/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
307371203 05 MO
institution
Provider Business Practice Location Address Details
Address
4901 Forest Park Ave
City
State
Zip
63108-1495
Phone Number
314-747-4769
Fax Number
888-824-2176
person
Provider Business Mailing Address Details
Address
4901 Forest Park Ave
City
State
Zip
63108-1495
Phone Number
314-747-4769
Fax Number
888-824-2176
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
License No.
2005018735 (Missouri)
Definition
Definition to come...
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