Physician Groups Lc
NPI #1124194212 in Saint Louis, Missouri
Provider Information
- NPI Number
- 1124194212
- Entity Type
- Organization
- Organization Name
- Physician Groups Lc
- Primary Specialty
- Clinic/Center - Medical Specialty
- Enumeration Date
- Nov 28, 2006
- Last Updated
- Mar 26, 2008
Practice Location
- Address
- 1040 N MASON RD
- Address 2
- SUITE 206
- City
- Saint Louis
- State
- Missouri
- ZIP Code
- 63141-6399
- Phone
- (314) 878-1950
Authorized Official
- Name
- RAYMOND P DAVIDSON II, MD
- Title
- PRESIDENT
- Phone
- (314) 286-2028
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Medical Specialty — Medical Specialty |
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