Organization
L BILLY WOUNDCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE JOHN BILLY MD (REGISTERED AGENT)
(636) 797-2611
Entity
Organization
Contact information
Practice address
3933 S BROADWAY, LIMB PRESERVATION CENTER, SAINT LOUIS, MO 63118-4601
(314) 865-7000
Mailing address
9375 E VISTA DR, HILLSBORO, MO 63050-3218
(636) 797-2611
(636) 797-2611
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
30514
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200026920
—
MO
Enumeration date
07/30/2012
Last updated
07/30/2012
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