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General NPI Number Information
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NPI Number | 1538955349
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Entity Type | Organization
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Legal Business Name | ORTHOPEDIC ASSOCIATES, LLC
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Dates
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Enumeration Date | 04/17/2025
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 1000 ELEVEN S STE 3C
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City | COLUMBIA
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State | IL
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Zip | 62236-1077
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Country | US
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Telephone | 314-569-0612
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Fax |
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Provider Business Mailing Address
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Address Line | 1050 OLD DES PERES RD STE 100
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City | SAINT LOUIS
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State | MO
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Zip | 63131-1873
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | PAUL ROBERTS
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Credential |
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Telephone | 314-569-0612
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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 |
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License Number State |
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