Individual
TIM BROTHERTON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3660 VISTA AVE, SAINT LOUIS, MO 63110-2540
(314) 977-6100
Mailing address
1402 S GRAND BLVD # 12, SAINT LOUIS, MO 63104-1004
(314) 977-6100
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
2023010843
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/14/2020
Last updated
12/12/2023
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