Provider Demographics
NPI:1952409971
Name:CHRISTOPHER T. LABONTE MD LLC
Entity type:Organization
Organization Name:CHRISTOPHER T. LABONTE MD LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:T
Authorized Official - Last Name:LABONTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-394-1379
Mailing Address - Street 1:1068 S WOODS MILL RD STE 220
Mailing Address - Street 2:
Mailing Address - City:TOWN AND COUNTRY
Mailing Address - State:MO
Mailing Address - Zip Code:63017-8333
Mailing Address - Country:US
Mailing Address - Phone:314-394-1379
Mailing Address - Fax:314-394-1377
Practice Address - Street 1:1068 S WOODS MILL RD STE 220
Practice Address - Street 2:
Practice Address - City:TOWN AND COUNTRY
Practice Address - State:MO
Practice Address - Zip Code:63017-8333
Practice Address - Country:US
Practice Address - Phone:314-394-1379
Practice Address - Fax:314-394-1377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO504588906Medicaid
MODF8249OtherMEDICARE RR
MO4920833OtherCIGNA
MO000015284Medicare PIN