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

St Louis University

Organization Pediatric Sports Medicine Physician · NPI 1336368034

St Louis University is a Pediatric Sports Medicine Physician in Saint Louis, Missouri. Registered with an NPI since 2007.

In the registry since
2007

Practice location Address checks out

1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone: (314) 577-5643
Show map & directions

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

Specialties & licences

Pediatric Sports Medicine Physician (primary) Taxonomy 2080S0010X

Record details

NPI number1336368034
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Alyce Lanxon — Executive Director · (314) 977-6828
Other names Slucare Dept Of Pediatric Sport Medicine; Slucare Dept Of Pediatric Sport Medicine
NPI enumeratedApril 24, 2007
Last updated in NPPESSeptember 21, 2021
Certification dateSeptember 21, 2021
Mailing address3545 Lindell Blvd Fl 3, Saint Louis, MO 63103-1020

Other providers in Saint Louis