Organization
PHYSICIAN GROUPS LC
Active
Other names
Carson Agee MD
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND P DAVIDSON II MD (PRESIDENT)
(314) 286-2028
Entity
Organization
Contact information
Practice address
2 PROGRESS POINT PARKWAY, SUITE 101C, O'FALLON, MO 63368
(636) 344-3102
Mailing address
670 MASON RIDGE CENTER DR, SUITE 300, SAINT LOUIS, MO 63141-8573
(314) 996-7644
(314) 996-7658
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
03/08/2007
Last updated
04/02/2008
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