Organization · Type 2 NPI

ST Louis University

Sports Medicine (Family Medicine) Physician · St. Louis, MO

NPI number 1306120183 Active

Practice location

1225 South Grand, 2L, Door 5
St. Louis, MO 63104-6310

Call (314) 977-4440 Map

Mailing address

3545 Lindell Blvd Fl 3
St. Louis, MO 63103-1020

Other practice locations

1755 S Grand Blvd, St. Louis, MO 63104-1540 · (314) 256-3850

Specialties and licenses

Taxonomy	Code	License
Sports Medicine (Family Medicine) Physician Primary	207QS0010X	None listed

Sports Medicine (Family Medicine) Physician: A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomecha…

10 other providers at this address

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NPI record

NPI: 1306120183
Entity type: Organization (Type 2)
Issued: Sep 28, 2011
Last updated: Sep 21, 2021
Status: Active

Other names

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Slucare Dept of FCM Sports Medicine · doing business as
Slucare Dept of FCM Sports Medicine · doing business as

Authorized official

Alyce Lanxon
Executive Director
(314) 977-6828

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1306120183

ST Louis University's National Provider Identifier is 1306120183, issued on Sep 28, 2011. The primary taxonomy on file is Sports Medicine (Family Medicine) Physician (207QS0010X), and the practice location is in St. Louis, MO. The record was last updated on Sep 21, 2021.