Provider Demographics
NPI:1073643987
Name:BROWNRIDGE PEDIATRICS AFTER HOURS P.C.
Entity Type:Organization
Organization Name:BROWNRIDGE PEDIATRICS AFTER HOURS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SETH
Authorized Official - Middle Name:JONATHAN
Authorized Official - Last Name:BROWNRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-731-2938
Mailing Address - Street 1:637 DUNN RD
Mailing Address - Street 2:SUITE 144
Mailing Address - City:HAZELWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63042-1755
Mailing Address - Country:US
Mailing Address - Phone:314-731-2938
Mailing Address - Fax:314-731-2145
Practice Address - Street 1:637 DUNN RD
Practice Address - Street 2:SUITE 144
Practice Address - City:HAZELWOOD
Practice Address - State:MO
Practice Address - Zip Code:63042-1755
Practice Address - Country:US
Practice Address - Phone:314-731-2938
Practice Address - Fax:314-731-2145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOPOO611417208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty