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Organization
OSAGE FAMILY CLINIC, LLC
Active
Organization
OSAGE FAMILY CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL BRAYFIELD MD (OWNER/MANAGING EMPLOYEE)
(573) 302-0670
Entity
Organization
Contact information
Practice address
1191 HIGHWAY KK, SUITE 202, OSAGE BEACH, MO 65065-3510
(573) 302-0670
(573) 302-0677
Mailing address
1836 LACKLAND HILL PKWY, SAINT LOUIS, MO 63146-3572
(314) 989-0300
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R1E19
MO
Other
Enumeration date
09/13/2006
Last updated
06/23/2008
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