Healthcare Provider Details

I. General information

NPI: 1467078931
Provider Name (Legal Business Name): ENNIO ANTONIO RIZZO ESPOSITO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2020
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 S NEW BALLAS RD STE 510
SAINT LOUIS MO
63141-8726
US

IV. Provider business mailing address

701 S NEW BALLAS RD STE 510
SAINT LOUIS MO
63141-8726
US

V. Phone/Fax

Practice location:
  • Phone: 314-251-6710
  • Fax:
Mailing address:
  • Phone: 314-251-6710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number2025047611
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: