Healthcare Provider Details

I. General information

NPI: 1003060880
Provider Name (Legal Business Name): ADVANCED ORTHOPEDICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2008
Last Update Date: 08/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8225 CLAYTON RD
SAINT LOUIS MO
63117-1107
US

IV. Provider business mailing address

8225 CLAYTON RD
SAINT LOUIS MO
63117-1107
US

V. Phone/Fax

Practice location:
  • Phone: 314-721-7325
  • Fax: 314-721-1157
Mailing address:
  • Phone: 314-721-7325
  • Fax: 314-721-1157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JASON BROWDY
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 314-721-7325