| Physician Groups Lc | |
|
3449 Pheasant Meadow Dr Suite 107 O Fallon MO 63368-7364 | |
| (636) 379-4140 | |
| (636) 379-4132 |
| Full Name | Physician Groups Lc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 3449 Pheasant Meadow Dr, 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 3449 Pheasant Meadow Dr Suite 107 O Fallon MO 63368-7364 Ph: (636) 379-4140 |
| NPI Number | 1609942747 |
|---|---|
| Provider Enumeration Date | 11/28/2006 |
| Last Update Date | 03/26/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609942747 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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