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Organization

PHYSICIAN GROUPS LC

Active
Other names
Office of Dr. Brick
Organization subpart
No

Provider details

NPI number
Authorized official
RAYMOND P DAVIDSON II MD (PRESIDENT)
(314) 286-2028
Entity
Organization

Contact information

Practice address
2536 S OLD HIGHWAY 94, SUITE 230, SAINT CHARLES, MO 63303-5612
(636) 928-1144
(636) 928-2476
Mailing address
670 MASON RIDGE CENTER DR, SUITE 300, SAINT LOUIS, MO 63141-8573
(314) 996-7644
(314) 996-7658

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary

Other

Enumeration date
11/28/2006
Last updated
01/04/2008
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