R&R 1 LLC
Organization Active NPI Adult Reconstructive Orthopaedic Surgery Physician · Sauget, IL
NPI 1962815340 · NPPES record last updated Jun 3, 2014
Key facts
- NPI
- 1962815340
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X
- License
- 036127269 (IL)
- Legal business name
- R&R 1 LLC
- Practice address
- 2071 Goose Lake Rd
Sauget, IL 62206-2822 - Phone
- (618) 857-2634
- NPI assigned
- Jun 3, 2014
- Organization subpart
- No
Authorized official
- Name
- Matthew Bradley, MD
- Title
- Owner
- Phone
- (314) 718-7276
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- RR 1 LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Reconstructive Orthopaedic Surgery Physician |
207XS0114X | 036127269 | IL | Yes |
Addresses
Primary practice location
2071 Goose Lake Rd
Sauget, IL 62206-2822
Mailing address
9272 Caddyshack Cir
Saint Louis, MO 63127-1932
Phone (314) 718-7276
Other providers in Sauget, IL
- Best Foot Forward Corp
- Samantha Fisher
- Starr'Retiece R Gibson
- Pillpack LLC
- Renal Treatment Centers-Illinois Inc
- Michael Riley Jr.
- Southern Illinois Health Care Foundation, Inc.
- Southern Illinois Healthcare Foundation, Inc.
- Southern Illinois Healthcare Foundation, Inc.
All providers in Sauget, IL · Adult Reconstructive Orthopaedic Surgery Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.