Individual provider · Type 1 NPI

Jacob Bast

Medical Physician Assistant · St. Louis, MO

NPI number 1194296186 Active

Practice location

10010 Kennerly Rd
St. Louis, MO 63128-2106

Call (314) 525-1000 Map

Mailing address

6439 Fordyce Bluffs Dr
St. Louis, MO 63129-5062

Other practice locations

  • 6439 Fordyce Bluffs Dr, St. Louis, MO 63129-5062 · (314) 933-6577

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X2020005531 (MO)

Medical Physician Assistant: Definition to come...

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About NPI 1194296186

Jacob Bast's National Provider Identifier is 1194296186, issued on Dec 17, 2018. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in St. Louis, MO. The record was last updated on Mar 15, 2020.