Organization
ST CHARLES ORTHOPAEDIC SURGERY ASSOCIATES INC.
Active
Organization
ST CHARLES ORTHOPAEDIC SURGERY ASSOCIATES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUZANN CROWDER (ADMINISTRATOR)
(636) 946-7050
Entity
Organization
Contact information
Practice address
400 1ST CAPITOL DR, STE 100, SAINT CHARLES, MO 63301-2881
(636) 946-7050
(636) 946-3368
Mailing address
9323 PHOENIX VILLAGE PKWY, O FALLON, MO 63366-4281
(636) 561-5030
(636) 561-5033
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
134766
BLUE CROSS BLUE SHIELD
MO
01
—
370199300
DOL
—
Enumeration date
05/23/2005
Last updated
07/21/2022
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