| Physician Groups Lc | |
|
2 Progress Point Ct Suite 101e O Fallon MO 63368-2208 | |
| (636) 344-2400 | |
| Not Available |
| Full Name | Physician Groups Lc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2 Progress Point Ct, O Fallon, Missouri |
| Authorized Official Name and Position | Raymond P Davidson (PRESIDENT) |
| Authorized Official Contact | 3142862028 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Physician Groups Lc 670 Mason Ridge Center Dr Suite 300 Saint Louis MO 63141-8573 Ph: (314) 996-7644 | Physician Groups Lc 2 Progress Point Ct Suite 101e O Fallon MO 63368-2208 Ph: (636) 344-2400 |
| NPI Number | 1215068655 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 04/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215068655 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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