Individual
CLAYTON E. THEBEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
621 S NEW BALLAS RD, SUITE 3016-B, SAINT LOUIS, MO 63141-8232
(314) 251-6339
(314) 251-4564
Mailing address
621 S NEW BALLAS RD, SUITE 3016-B, SAINT LOUIS, MO 63141-8232
(314) 251-6339
(314) 251-4564
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2006004084
MO
Other
Enumeration date
07/06/2006
Last updated
07/08/2007
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