person
Dr. Brock Davis Ridenour, MD
Plastic and Reconstructive Surgery Physician in Saint Louis, Missouri
NPI 1164536710

Brock Davis Ridenour is a Plastic and Reconstructive Surgery Physician based in Saint Louis, MO and is specialized in Plastic and Reconstructive Surgery. Brock Davis Ridenour practices in Saint Louis, MO and has the professional credentials of MD. The NPI Number for Brock Davis Ridenour is 1164536710 and holds a License No. 101951 (Missouri).

The current practice location address for Brock Davis Ridenour is 12460 Olive Blvd, Saint Louis, MO and can be reached out via phone at 314-909-1202 and via fax at 314-909-1290.

Location: 12460 Olive Blvd, Saint Louis, MO, 63141-6409
person
Provider Profile Details
NPI Number
1164536710
Provider Name
Brock Davis Ridenour
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
12460 Olive Blvd, Saint Louis, MO, 63141-6409
Phone Number
314-909-1202
Fax Number
314-909-1290
Provider Enumeration Date
08/19/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
12460 Olive Blvd
City
State
Zip
63141-6409
Phone Number
314-909-1202
Fax Number
314-909-1290
person
Provider Business Mailing Address Details
Address
12460 Olive Blvd
City
State
Zip
63141-6409
Phone Number
314-909-1202
Fax Number
314-909-1290
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Surgery
Speciality
Plastic and Reconstructive Surgery
Taxonomy
License No.
101951 (Missouri)
Definition
A surgeon who specializes in plastic and reconstructive surgery.
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