Individual
BRIAN ANTHONY FISSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12639 OLD TESSON RD, SUITE 115, SAINT LOUIS, MO 63128-2786
(314) 849-0311
(314) 849-4423
Mailing address
12639 OLD TESSON RD, SUITE 115, SAINT LOUIS, MO 63128-2786
(314) 849-0311
(314) 849-4423
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
2009012784
MO
207XX0801X
Orthopaedic Trauma Physician
2009012784
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053515726
—
MO
Enumeration date
06/14/2007
Last updated
07/17/2019
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