MEDICARE: PAYTON BODDEN PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant

General Provider Information

NPI Number	:	1891658522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAYTON BODDEN PA-C

Provider Business Mailing Address
First Line	:	11125 DUNN RD STE 301
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-6132
Country	:	US
Telephone Number	:	314-273-2234
Fax Number	:

Provider Business Practice Location Address
First Line	:	11125 DUNN RD STE 301
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-6132
Country	:	US
Telephone Number	:	314-273-2234
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2025
Last Update Date	:	12/09/2025

Similar Medicare Providers

1073491635 — SKYLAR GODARD
Practice Location Address:

11125 DUNN RD STE 301
SAINT LOUIS, MO
63136-6132

Practice Phone: 314-953-8250
Practice Fax:

1952599631 — MS. JILL R SPECA PA
Practice Location Address:

11125 DUNN RD STE 301
SAINT LOUIS, MO
63136-6132

Practice Phone: 314-953-8250
Practice Fax: 314-953-8255

1083617294 — MORIN MICHAEL HANSON M.D.
Practice Location Address:

11125 DUNN RD , STE 402
SAINT LOUIS, MO
63136-6132

Practice Phone: 314-741-3400
Practice Fax: 314-741-4357

1124011028 — DR. LALITHKUMAR K CHOUHAN MD
Practice Location Address:

11125 DUNN RD , STE 204
SAINT LOUIS, MO
63136-6132

Practice Phone: 314-839-5522
Practice Fax: 314-839-5351

1528051422 — ROBERT G LUTAN MD
Practice Location Address:

11125 DUNN RD , SUITE 204
SAINT LOUIS, MO
63136-6132

Practice Phone: 314-839-5522
Practice Fax: 314-839-5351

1437142338 — EDWARD S WEISS MD
Practice Location Address:

11125 DUNN RD , SUITE 204
SAINT LOUIS, MO
63136-6132

Practice Phone: 314-839-5522
Practice Fax: 314-839-5351

Directions to “ PAYTON BODDEN PA-C” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.