Provider Demographics
NPI:1861640823
Name:LAGOW, JULIA (DO)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:LAGOW
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:
Other - Last Name:FELDMEIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:621 S NEW BALLAS RD
Mailing Address - Street 2:SUITE 4005B
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8232
Mailing Address - Country:US
Mailing Address - Phone:314-251-5016
Mailing Address - Fax:314-567-1846
Practice Address - Street 1:621 S NEW BALLAS RD
Practice Address - Street 2:SUITE 4005B
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8232
Practice Address - Country:US
Practice Address - Phone:314-251-5016
Practice Address - Fax:314-567-1846
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009019549207V00000X
FLOS11592207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1861640823Medicaid
MO152800319Medicare PIN