Provider Demographics
NPI:1255835054
Name:MEDBILLING LLC
Entity Type:Organization
Organization Name:MEDBILLING LLC
Other - Org Name:PERFORMANCE ORTHOPEDICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:KOSTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-317-1312
Mailing Address - Street 1:10448 OLD OLIVE STREET RD STE 200
Mailing Address - Street 2:
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-5927
Mailing Address - Country:US
Mailing Address - Phone:314-317-1312
Mailing Address - Fax:314-317-1398
Practice Address - Street 1:10448 OLD OLIVE STREET RD STE 200
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-5927
Practice Address - Country:US
Practice Address - Phone:314-317-1312
Practice Address - Fax:314-317-1398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-19
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO113686207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty