OrganizationActive
Physician Groups Lc
NPI 1659415578 · Colon & Rectal Surgery Physician · Saint Louis, MO
Provider details
- NPI number
- 1659415578
- Entity type
- Organization
- Primary specialty
- Colon & Rectal Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Raymond Davidson, President(314) 286-2028
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
11155 Dunn Rd
Suite 312e Building 1
Saint Louis, MO 63136-6150
Phone: (314) 741-0430
Approximate (ZIP-level) locationGet directions
Mailing address
670 Mason Ridge Center Dr
Saint Louis, MO 63141-8573
Other names (DBA / former)
- Doing business as
- North County Colorectal Surgery
Registry dates
- Enumerated
- 2007-02-16
- Last updated
- 2008-04-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.