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General NPI Number Information
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NPI Number | 1427124148
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Entity Type | Organization
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Legal Business Name | WILLIAM SEDGWICK MD ORTHOPAEDIC SURGERY AND SPORTS MEDICINE PC
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 09/30/2010
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Provider Practice Location Address
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Address Line | 226 S WOODS MILL SUITE 47W
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City | CHESTERFIELD
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State | MO
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Zip | 63017
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Country | US
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Telephone | 314-878-6001
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Fax | 314-878-2709
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Provider Business Mailing Address
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Address Line | 226 S WOODS MILL SUITE 47W
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City | CHESTERFIELD
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State | MO
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Zip | 63017
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Country | US
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Telephone | 314-878-6001
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Fax | 314-878-2709
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM GLENN SEDGWICK
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Credential | MD
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Telephone | 314-878-6001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | R7073
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License Number State | MO
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