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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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