Provider Demographics
NPI:1720860133
Name:MISSOURI ORTHOPEDIC AND COMP CENTRAL, LLC
Entity Type:Organization
Organization Name:MISSOURI ORTHOPEDIC AND COMP CENTRAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:636-202-1492
Mailing Address - Street 1:14825 N OUTER 40 RD STE 310
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-2152
Mailing Address - Country:US
Mailing Address - Phone:314-392-5042
Mailing Address - Fax:
Practice Address - Street 1:14825 N OUTER 40 RD STE 310
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-2152
Practice Address - Country:US
Practice Address - Phone:314-392-5042
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Multi-Specialty