Physician Groups LC

Surgery Physician · O'Fallon, MO

Organization Active NPI

NPI number 1164553590

Practice location

2 Progress Point Parkway
Suite 101c
O'Fallon, MO 63368
Phone
(636) 344-3102

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NPI record

NPI
1164553590
Entity type
Organization (Type 2)
Enumeration date
March 8, 2007
Last updated
April 2, 2008
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Surgery Physician Primary 208600000X — —

Mailing address

670 Mason Ridge Center Dr
Suite 300
Saint Louis, MO 63141-8573
Phone
(314) 996-7644
Fax
(314) 996-7658

Authorized official

Name
Raymond P Davidson II, MD
Title
President
Phone
(314) 286-2028

Other names

  • Carson Agee MD

About Physician Groups LC

Physician Groups LC is a healthcare organization registered in the NPI registry with the primary taxonomy Surgery Physician (code 208600000X). The practice location is 2 Progress Point Parkway, Suite 101c, O'Fallon, MO 63368. The NPI number 1164553590 was assigned on March 8, 2007 and the record was last updated on April 2, 2008.

The authorized official for this organization is Raymond P Davidson II, MD, President.

Frequently asked questions

What is the NPI number of Physician Groups LC?

The NPI number is 1164553590.

What is the phone number of Physician Groups LC?

The phone number listed for the practice location is (636) 344-3102.

Where is Physician Groups LC located?

2 Progress Point Parkway, Suite 101c, O'Fallon, MO 63368.

What is the taxonomy code for Physician Groups LC?

The primary taxonomy code is 208600000X – Surgery Physician.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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