OrganizationActive
St.. Louis University
NPI 1780948018 · Sports Medicine (Family Medicine) Physician · St Louis, MO
Provider details
- NPI number
- 1780948018
- Entity type
- Organization
- Primary specialty
- Sports Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Alyce Lanxon, Executive Director
Practice location
1225 South Grand, 2l, Door 5
St Louis, MO 63104
Phone: (314) 977-4700
Mailing address
3545 Lindell Blvd Fl 3
Saint Louis, MO 63103-1020
Registry dates
- Enumerated
- 2012-07-02
- Last updated
- 2021-09-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.