Healthcare Provider Details

I. General information

NPI: 1770012767
Provider Name (Legal Business Name): WILLIAM WEBSTER BEHRENS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2017
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12639 OLD TESSON RD
SAINT LOUIS MO
63128-2711
US

IV. Provider business mailing address

3635 VISTA AVE
SAINT LOUIS MO
63117
US

V. Phone/Fax

Practice location:
  • Phone: 314-849-0311
  • Fax:
Mailing address:
  • Phone: 314-577-8850
  • Fax: 314-268-5121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number2023003713
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberT6519
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: