Healthcare Provider Details

I. General information

NPI: 1033484175
Provider Name (Legal Business Name): RAYMOND A. BRICKHOUSE, DPM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2012
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 CLAYTON RD STE 412
SAINT LOUIS MO
63117-1850
US

IV. Provider business mailing address

6400 CLAYTON RD STE 412
SAINT LOUIS MO
63117-1850
US

V. Phone/Fax

Practice location:
  • Phone: 314-381-1800
  • Fax: 314-442-7749
Mailing address:
  • Phone: 314-381-1800
  • Fax: 314-422-7749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number2008026233
License Number StateMO

VIII. Authorized Official

Name: DR. RAYMOND ANGELO BRICKHOUSE JR.
Title or Position: OWNER
Credential: DPM
Phone: 314-381-1800