Individual
PATRICK REARDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12639 OLD TESSON RD, SAINT LOUIS, MO 63128-2711
(314) 849-0311
Mailing address
12639 OLD TESSON RD, SAINT LOUIS, MO 63128-2711
(314) 849-0311
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
2022021266
MO
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
2022021266
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2016
Last updated
09/26/2022
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