OrganizationActive
Blue Bayou Service Inc
NPI 1144577305 · General Practice Physician · Saint Louis, MO
Provider details
- NPI number
- 1144577305
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- William Bronson, Ceo(314) 502-1300
- License
- 12345 (MO)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1310 Papin St
Saint Louis, MO 63103-3132
Phone: (314) 502-1300
Approximate (ZIP-level) locationGet directions
Mailing address
1310 Papin St
Saint Louis, MO 63103-3132
Registry dates
- Enumerated
- 2012-08-07
- Last updated
- 2012-09-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.