Organization
CALDWELL GENERAL PRACTICE, INC.
Active
Other names
General Practice Inc
Organization subpart
No
Provider details
NPI number
Authorized official
REYNAL LEON CALDWELL SR. D.O. (CEO PHYSICIAN)
(314) 521-7768
Entity
Organization
Contact information
Practice address
2880 NETHERTON DR, SUITE 103, ST. LOUIS, MO 63136
(314) 521-7768
(314) 838-3683
Mailing address
2880 NETHERTON DR, SUITE 103, ST. LOUIS, MO 63136
(314) 521-7768
(314) 838-3683
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R5E11
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
242386712
—
MO
Enumeration date
07/08/2005
Last updated
05/03/2013
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