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Organization

ORTHOPEDIC CARE OF ST. LOUIS, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEFFREY W MARTIN M.D. (PHYSICIAN, OWNER)
(314) 434-0030
Entity
Organization

Contact information

Practice address
1040 N MASON RD, SUITE G03, SAINT LOUIS, MO 63141-6399
(314) 434-0030
(314) 434-0009
Mailing address
1040 N MASON RD, SUITE G03, SAINT LOUIS, MO 63141-6399
(314) 434-0030
(314) 434-0009

Taxonomy

Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DD5877
RR MEDICARE
MO
Enumeration date
03/16/2007
Last updated
10/14/2014
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