Organization · Type 2 NPI

ST Louis University

Pediatric Sports Medicine Physician · St. Louis, MO

NPI number 1336368034 Active

Practice location

1465 S Grand Blvd
St. Louis, MO 63104-1003

Call (314) 577-5643 Map

Mailing address

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

Specialties and licenses

Taxonomy	Code	License
Pediatric Sports Medicine Physician Primary	2080S0010X	None listed

Pediatric Sports Medicine Physician: A pediatrician who is 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, biomechanics, nutrition, psychology,…

572 other providers at this address

NPI record

NPI: 1336368034
Entity type: Organization (Type 2)
Issued: Apr 24, 2007
Last updated: Sep 21, 2021
Status: Active

Other names

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Slucare Dept of Pediatric Sport Medicine · doing business as
Slucare Dept of Pediatric Sport 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 1336368034

ST Louis University's National Provider Identifier is 1336368034, issued on Apr 24, 2007. The primary taxonomy on file is Pediatric Sports Medicine Physician (2080S0010X), and the practice location is in St. Louis, MO. The record was last updated on Sep 21, 2021.