MEDICARE: PHYSICIAN GROUPS LC

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	207KA0200X	Allergy Physician

General Provider Information

NPI Number	:	1801089057
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIAN GROUPS LC

Provider Business Mailing Address
First Line	:	670 MASON RIDGE CENTER DR
Second Line	:	SUITE 300
City	:	SAINT LOUIS
State	:	MO
Zip	:	63141-8573
Country	:	US
Telephone Number	:	314-996-7644
Fax Number	:	314-996-7658

Provider Business Practice Location Address
First Line	:	301 N WASHINGTON ST
Second Line	:	SUITE 5
City	:	FARMINGTON
State	:	MO
Zip	:	63640-1751
Country	:	US
Telephone Number	:	573-756-1744
Fax Number	:	573-756-2499

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RAYMOND P DAVIDSON II
Credential	:	MD
Telephone Number	:	314-286-2028

Provider Enumeration Date	:	08/21/2007
Last Update Date	:	01/07/2008

Similar Medicare Providers

1124044961 — STELLA M NAEGER
Practice Location Address:

301 N WASHINGTON ST
FARMINGTON, MO
63640-1751

Practice Phone: 573-756-6101
Practice Fax: 573-756-6420

1629185103 — KEVIN BOATRIGHT
Practice Location Address:

301 N WASHINGTON ST , SUITE 5
FARMINGTON, MO
63640-1751

Practice Phone: 573-756-1744
Practice Fax: 573-756-2499

1982788386 — MRS. JANET M BROWN BC-HIS
Practice Location Address:

301 N WASHINGTON ST , SUITE 4B
FARMINGTON, MO
63640-1751

Practice Phone: 573-756-5550
Practice Fax: 573-756-5255

1972459147 — TRACY M PROCTOR
Practice Location Address:

1085 MAPLE ST
FARMINGTON, MO
63640-1955

Practice Phone: 573-670-5136
Practice Fax:

1881549038 — CHRISTINA MCCARTHY
Practice Location Address:

1085 MAPLE ST
FARMINGTON, MO
63640-1955

Practice Phone: 573-756-5353
Practice Fax:

1255125209 — CLAIRE CORTNER
Practice Location Address:

537 W KARSCH BLVD
FARMINGTON, MO
63640-3312

Practice Phone: 573-747-4133
Practice Fax:

Directions to “PHYSICIAN GROUPS LC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.