Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 2004018585 | MO |
NPI | 1215985940 |
---|---|
Provider Name | Dr. Betty Louise Baldridge |
First Address | Saint Louis, MO 63110-3010 |
Second Address | St Peters, MO 63376-1514 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2006 |
Last Update Date | 08/07/2007 |