MEDICARE: JASON A. BROWDY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	036.117297	IL
2	207X00000X	Orthopaedic Surgery Physician	2004002148	MO

General Provider Information

NPI Number	:	1134120447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON A. BROWDY M.D.

Provider Business Mailing Address
First Line	:	8225 CLAYTON RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63117-1107
Country	:	US
Telephone Number	:	314-721-7325
Fax Number	:	314-721-1157

Provider Business Practice Location Address
First Line	:	633 EMERSON RD STE 100
Second Line	:
City	:	CREVE COEUR
State	:	MO
Zip	:	63141-6739
Country	:	US
Telephone Number	:	314-991-2150
Fax Number	:	314-991-2149

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	02/20/2019

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