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Organization
MISSOURI BAPTIST HOSPITAL OF SULLIVAN
Active
Organization
MISSOURI BAPTIST HOSPITAL OF SULLIVAN
Active
Other names
St. Clair Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND P. DAVIDSON II MD (PRESIDENT)
(314) 286-2025
Entity
Organization
Contact information
Practice address
875 N COMMERCIAL AVE, SAINT CLAIR, MO 63077-1118
(636) 629-7467
(636) 629-7464
Mailing address
670 MASON RIDGE CENTER DR, STE. 300, SAINT LOUIS, MO 63141-8573
(314) 996-7644
(314) 996-7658
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
Other
Enumeration date
02/11/2008
Last updated
02/11/2008
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