DR. Brock Davis Ridenour, MD is a plastic and reconstructive surgery surgery in Saint Louis, MO. The provider is a surgeon who specializes in plastic and reconstructive surgery. DR. Brock Davis Ridenour, MD NPI is 1164536710. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
12460 OLIVE BLVD
SUITE 202
SAINT LOUIS, MO
ZIP 63141-409
Phone: (314) 909-1202
Fax: (314) 909-1290
The NPI 1164536710 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.
The enumeration date for this NPI number is 8/19/2006 and was last updated on 7/8/2007.