| Physician Groups Lc | |
|
1 Dillon Plaza Dr High Ridge MO 63049-2478 | |
| (636) 677-3012 | |
| (636) 677-3174 |
| Full Name | Physician Groups Lc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1 Dillon Plaza Dr, High Ridge, 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 1 Dillon Plaza Dr High Ridge MO 63049-2478 Ph: (636) 677-3012 |
| NPI Number | 1710053897 |
|---|---|
| Provider Enumeration Date | 11/28/2006 |
| Last Update Date | 03/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710053897 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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