|
| |
|
2630 Highway K O Fallon MO 63368-6624 | |
| (636) 240-5454 | |
| (636) 980-5335 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 2630 Highway K, 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 |
|---|---|
670 Mason Ridge Center Dr Suite 300 Saint Louis MO 63141-8573 Ph: (314) 996-7644 | 2630 Highway K O Fallon MO 63368-6624 Ph: (636) 240-5454 |
| NPI Number | 1821164955 |
|---|---|
| Provider Enumeration Date | 11/28/2006 |
| Last Update Date | 03/26/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821164955 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Kevin L. Threlkeld, M.d., Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 204 N Main St, O Fallon, MO 63366 Phone: 636-240-3420 | |
Internal Medicine At Winghaven Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5551 Winghaven Blvd Ste 290, O Fallon, MO 63368 Phone: 636-695-2575 Fax: 314-590-5938 | |
O'fallon Pain Relief Associates Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2682 Babble Creek Ln, O Fallon, MO 63368 Phone: 636-978-3000 Fax: 636-978-1821 | |
Chiro Co Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2917 Highway K Ste F, O Fallon, MO 63368 Phone: 314-239-2427 | |
Progress West Healthcare Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Two Progress Point Parkway, O Fallon, MO 63368 Phone: 314-996-3628 Fax: 314-996-3610 | |