Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Missouri Baptist Hospital of Sullivan

Organization Family Medicine Physician · NPI 1790953909

Missouri Baptist Hospital of Sullivan is a Family Medicine Physician in Saint Clair, Missouri. Registered with an NPI since 2008.

In the registry since
2008
Specialties on file
2

Practice location Address checks out

875 N Commercial Ave
Saint Clair, MO 63077-1118
Phone: (636) 629-7467
Fax: (636) 629-7464
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Obstetrics & Gynecology Physician Taxonomy 207V00000X

Record details

NPI number1790953909
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Raymond Davidson — President · (314) 286-2025
Other names St. Clair Clinic
NPI enumeratedFebruary 11, 2008
Last updated in NPPESFebruary 11, 2008
Mailing address670 Mason Ridge Center Dr, Ste. 300, Saint Louis, MO 63141-8573

Other providers in Saint Clair