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General NPI Number Information
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NPI Number | 1073427761
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Entity Type | Organization
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Legal Business Name | DECKER SPORTS AND SPINE
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Dates
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Enumeration Date | 09/30/2026
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Last Update Date | 09/30/2026
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Provider Practice Location Address
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Address Line | 502 BAILEY RD
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City | CRYSTAL CITY
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State | MO
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Zip | 63019-1702
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Country | US
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Telephone | 314-270-2405
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Fax |
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Provider Business Mailing Address
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Address Line | 502 BAILEY RD
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City | CRYSTAL CITY
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State | MO
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Zip | 63019-1702
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Country | US
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Telephone | 314-270-2405
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN/PARTNER
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Name | GREGORY DECKER
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Credential | MD
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Telephone | 314-270-2405
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State | NULL
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