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Individual

DR. RAYMOND ANGELO BRICKHOUSE JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M

Contact information

Practice address
3535 S JEFFERSON AVE STE 201, SAINT LOUIS, MO 63118-3922
(314) 567-2061
(866) 927-4145
Mailing address
PO BOX 790, EDWARDSVILLE, IL 62025-0790
(267) 258-7344
(866) 927-4145

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
0103300984
VA
213ES0103X
Foot & Ankle Surgery Podiatrist
016005384
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
2008026233
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1437314812
MO
Enumeration date
07/24/2008
Last updated
05/11/2010
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