Healthcare Provider Details

I. General information

NPI: 1770544066
Provider Name (Legal Business Name): ARTHRITIS CONSULTANTS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 06/26/2024
Certification Date: 06/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

522 N NEW BALLAS RD STE 240
SAINT LOUIS MO
63141
US

IV. Provider business mailing address

522 N NEW BALLAS RD STE 240
SAINT LOUIS MO
63141-6819
US

V. Phone/Fax

Practice location:
  • Phone: 314-567-5100
  • Fax: 314-567-3387
Mailing address:
  • Phone: 314-567-5100
  • Fax: 314-567-3387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: DEBORAH MARY MOORE
Title or Position: PRACTICE MANAGER
Credential:
Phone: 314-567-5100