Organization
MISSOURI BAPTIST HOSPITAL OF SULLIVAN
Active
Other names
St. Clair Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND P. DAVIDSON II MD (PRESIDENT)
(314) 286-2025
Entity
Organization
Contact information
Practice address
875 N COMMERCIAL AVE, SAINT CLAIR, MO 63077-1118
(636) 629-7467
(636) 629-7464
Mailing address
670 MASON RIDGE CENTER DR, STE. 300, SAINT LOUIS, MO 63141-8573
(314) 996-7644
(314) 996-7658
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
Other
Enumeration date
02/11/2008
Last updated
02/11/2008
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