IndividualActive
Kevin Lickenbrock, M.D.
NPI 1174643845 · Family Medicine Physician · Saint Louis, MO
Provider details
- NPI number
- 1174643845
- Entity type
- Individual
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 100453 (MO)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2900 Lemay Ferry Rd
Suite 100
Saint Louis, MO 63125-3900
Phone: (314) 543-5294
Street-level locationGet directions
Mailing address
1159 Albany Ct
Saint Louis, MO 63119-4733
Registry dates
- Enumerated
- 2007-03-29
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.