OrganizationActive
Physician Groups Lc
NPI 1609942747 · Multi-Specialty Clinic/Center · O Fallon, MO
Provider details
- NPI number
- 1609942747
- Entity type
- Organization
- Primary specialty
- Multi-Specialty Clinic/CenterAmbulatory Health Care Facilities
- Authorized official
- Raymond Davidson, President
Practice location
3449 Pheasant Meadow Dr
Suite 107
O Fallon, MO 63368-7364
Phone: (636) 379-4140
Fax: (636) 379-4132
Mailing address
670 Mason Ridge Center Dr
Saint Louis, MO 63141-8573
Registry dates
- Enumerated
- 2006-11-28
- Last updated
- 2008-03-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.