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General NPI Number Information
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NPI Number | 1396347886
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Entity Type | Organization
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Legal Business Name | LINK PRIMARY CARE LLC
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Dates
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Enumeration Date | 11/10/2020
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Last Update Date | 11/10/2020
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Provider Practice Location Address
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Address Line | 1034 S BRENTWOOD BLVD STE 530
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City | RICHMOND HEIGHTS
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State | MO
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Zip | 63117-1271
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Country | US
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Telephone | 314-798-7422
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Fax | 314-293-6861
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Provider Business Mailing Address
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Address Line | 1034 S BRENTWOOD BLVD STE 530
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City | RICHMOND HEIGHTS
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State | MO
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Zip | 63117-1271
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Country | US
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Telephone | 314-798-7422
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Fax | 314-293-6861
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Authorized Official
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Title or Position | MEMBER
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Name | DR. JEFFREY DAVIS
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Credential | MD, MBA
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Telephone | 314-740-5820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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