BRUCE R BACON

SAINT LOUIS, MO
NPI1083622963
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207RG0100X Internal Medicine Gastroenterology
(Licence: MO  R3L81)
Enumeration Date2006-08-04
Last Update Date2008-03-18
Business Address
BRUCE R BACON MD
3660 VISTA AVE
SAINT LOUIS, MO 63110-2540
Phone number: 314-577-8764
Mailing Address
BRUCE R BACON MD
3691 RUTGER ST PROVIDER ENROLLMENT
SAINT LOUIS, MO 63110-2515
Phone number: 314-977-4440
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