1417903022 NPI number — DR. THOMAS ROBERT FORGET JR. M.D.

Table of content: MS. PATRICIA A O'NEILL M.S.,CCC-A (NPI 1821036963)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417903022 NPI number — DR. THOMAS ROBERT FORGET JR. M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FORGET
Provider First Name:
THOMAS
Provider Middle Name:
ROBERT
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417903022
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/12/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
621 S NEW BALLAS RD
Provider Second Line Business Mailing Address:
SUITE 297A
Provider Business Mailing Address City Name:
SAINT LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63141-8232
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-251-6364
Provider Business Mailing Address Fax Number:
314-251-7897

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
621 S NEW BALLAS RD
Provider Second Line Business Practice Location Address:
SUITE 297A
Provider Business Practice Location Address City Name:
SAINT LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63141-8232
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-251-6364
Provider Business Practice Location Address Fax Number:
314-251-7897
Provider Enumeration Date:
05/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207T00000X , with the licence number:  106306 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 261839808 . This is a "CCN" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 431725782 . This is a "MULTIPLAN" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: AETNA . This is a "7482181" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 431725782 . This is a "GREAT WEST HEALTH CARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 431725782 . This is a "HFN" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 431725782 . This is a "ONE HEALTH PLAN" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 130525 . This is a "ALLIANCE BLUE CROSS" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 130539 . This is a "GROUP HEALTH PLAN" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 431725782 . This is a "CIGNA" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 130525 . This is a "BLUE CROSS" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 294881 . This is a "HEALTHLINK PPO" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 431725782 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 431725782 . This is a "PRIVATE HEALTHCARE SERVIC" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 431725782 . This is a "UNICARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 431725782 . This is a "CHAMPUS" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 431725782 . This is a "MERCY HEALTH PLANS" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




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