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Contact Information

JEFFREY S BOBERG, DPM
9323 PHOENIX VILLAGE PKWY
O'FALLON, MO63368-4281
 Phone: 636-561-0871
 Fax: 636-561-5032
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
 

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for JEFFREY S BOBERG · (Male)

NPI # 1437264595
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 08/20/2006
Last updated 05/10/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 000570
  • MO Medicaid 302436829
  • IL Other 5031350002 DMERC
  • MO Other 5031350001 DMERC
  • MO Other P00081678 RAILROAD MEDICARE
Hospital affiliation(s)
  • BARNES-JEWISH ST PETERS HOSPITAL - (Acute Care)
    10 HOSPITAL DR
    SAINT PETERS, MO 63376
  • ST LUKES HOSPITAL - (Acute Care)
    232 S WOODS MILL RD
    CHESTERFIELD, MO 63017
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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