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General NPI Number Information
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NPI Number | 1346650884
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Entity Type | Organization
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Legal Business Name | MATTHEW T. RICKS DO LLC
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Dates
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Enumeration Date | 05/06/2014
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 2355 DOUGHERTY FERRY RD 430
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City | SAINT LOUIS
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State | MO
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Zip | 63122-3325
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Country | US
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Telephone | 314-965-8410
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Fax | 314-965-8756
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Provider Business Mailing Address
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Address Line | 2355 DOUGHERTY FERRY RD 430
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City | SAINT LOUIS
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State | MO
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Zip | 63122-3325
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Country | US
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Telephone | 314-965-8410
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Fax | 314-965-8756
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Authorized Official
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Title or Position | OWNER
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Name | MATTHEW RICKS
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Credential | DO
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Telephone | 314-965-8410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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