Provider Demographics
NPI:1871594184
Name:STRECKER, WILLIAM B (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:B
Last Name:STRECKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 OLD DES PERES RD.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-1865
Mailing Address - Country:US
Mailing Address - Phone:314-569-0612
Mailing Address - Fax:314-966-0664
Practice Address - Street 1:1050 OLD DES PERES RD.
Practice Address - Street 2:SUITE 100
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-1865
Practice Address - Country:US
Practice Address - Phone:314-569-0612
Practice Address - Fax:314-966-0664
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR6921207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0900305OtherUNITED HEALTHCARE
MO41158OtherCOVENTRY
MO200040223OtherMEDICARE RAILROAD
MO102331OtherHEALTHLINK
MO3090056OtherCIGNA
MO4001067OtherAETNA
MO4208030001Medicare NSC
MOA11539Medicare UPIN
MO4001067OtherAETNA