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KEVIN JAMES LICKENBROCK M.D.
NPI 1174643845
Family Medicine in Saint Louis, MO

Active since March 29, 2007
2900 LEMAY FERRY RD, SUITE 100, SAINT LOUIS, MO 63125(314) 543-5294 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kevin James Lickenbrock M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEVIN JAMES LICKENBROCK M.D. (NPI 1174643845) is an individual family medicine provider in Saint Louis, Missouri, licensed in Missouri (100453) and active in the NPI registry since March 2007.

NPPES Registry Identity

NPI1174643845
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameKEVIN JAMES LICKENBROCKCredential: M.D.
Location Address2900 LEMAY FERRY RD, SUITE 100Saint Louis, MO 63125-3900
Mailing Address1159 Albany CtSaint Louis, MO 63119-4733 · (314) 961-4098
Phone(314) 543-5294
Sole ProprietorNo
Enumeration DateMarch 29, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1174643845 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MO · 100453
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
2900 LEMAY FERRY RD, Saint Louis, MO 63125
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Other Identifiers 1

Medicare UPINE43813MO

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHAN P VO, MD
Hearing Instrument Specialist
2900 LEMAY FERRY RD, #214
ST LOUIS, MO 63125
St. Louis County (314) 894-9192
DR. JOSEPH PAUL WOOD MD
Internal Medicine
2900 LEMAY FERRY RD, SUITE 208
SAINT LOUIS, MO 63125
St. Louis County (314) 543-5984
TRIAD LABS INC
Clinical Medical Laboratory
2900 LEMAY FERRY RD, STE 205
SAINT LOUIS, MO 63125
St. Louis County (314) 200-6450
PLASTIC SURGERY CONCEPTS, PC
Plastic Surgery
2900 LEMAY FERRY RD, SUITE 225
SAINT LOUIS, MO 63125
St. Louis County (314) 894-4684
DR. KAREN ALBERS LICKENBROCK M.D.
Family Medicine
2900 LEMAY FERRY RD
SAINT LOUIS, MO 63125
St. Louis County (314) 543-5294
THYROID SPECIALTY LABORATORY INC
Clinical Medical Laboratory
2900 LEMAY FERRY RD, SUITE 114
SAINT LOUIS, MO 63125
St. Louis County (314) 845-7345
MRS. MELISSA P PENNINGTON PA-C
Physician Assistant
2900 LEMAY FERRY RD
SAINT LOUIS, MO 63125
St. Louis County (314) 543-5294
MS. TERESA LYNN BREWER APRN, BC
Nurse Practitioner (Family)
2900 LEMAY FERRY RD
SAINT LOUIS, MO 63125
St. Louis County (314) 543-5294

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kevin Lickenbrock's NPI number?

The NPI number for Kevin Lickenbrock is 1174643845. It was assigned to this individual provider in the NPPES registry on March 29, 2007.

Where is Kevin Lickenbrock located?

Kevin Lickenbrock practices at 2900 Lemay Ferry Rd Suite 100, Saint Louis, MO 63125. The listed phone number is (314) 543-5294.

What is Kevin Lickenbrock's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Kevin Lickenbrock was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.