# OSAGE FAMILY CLINIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215031737
- **Authorized official:** DR. SAMUEL BRAYFIELD MD (OWNER/MANAGING EMPLOYEE)
- **Authorized official phone:** (573) 302-0670

## Contact information

- **Practice address:** 1191 HIGHWAY KK, SUITE 202, OSAGE BEACH, MO 65065-3510
- **Practice address phone:** (573) 302-0670
- **Practice address fax:** (573) 302-0677
- **Mailing address:** 1836 LACKLAND HILL PKWY, SAINT LOUIS, MO 63146-3572
- **Mailing address phone:** (314) 989-0300

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | R1E19 | MO | Yes |

## Other

- **Enumeration date:** 09/13/2006
- **Last updated:** 06/23/2008