TONY E SUDEKUM (NPI# 1184779399) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184779399 |
| Entity Type | Individual |
| Full Name | TONY E SUDEKUM |
| Credential | M.D. |
| Practice Address |
830 Waterbury Falls Dr O Fallon MO 63368-2215 |
| Practice Telephone | 6367303000 |
| Practice Fax Number | 6367303010 |
| Mailing Telephone | 6367303000 |
| Mailing Fax Number | 6367303010 |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2007-11-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0105X |
Surgery Specialization: Surgery of the Hand |
111635 | MO | Allopathic & Osteopathic Physicians |
| N | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
111635 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | HEALTHLINK | 321307 | 01 |
| Street Address |
830 WATERBURY FALLS DR |
| City | O FALLON |
| State | MO |
| Zip Code | 63368-2215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417935974 | Thomas F Wright | Family Medicine | 830 Waterbury Falls Dr, Ste 202, O Fallon, MO 63368-2215 | 2006-01-05 |
| 1447472519 | Midwest Special Surgery, P.C. | Surgery | 830 Waterbury Falls Dr, O Fallon, MO 63368-2215 | 2007-05-02 |
| 1972721025 | Lakeview Medical Group Inc | Internal Medicine | 830 Waterbury Falls Dr, Ste 202, O Fallon, MO 63368-2215 | 2007-04-23 |
| 1710009550 | Outpatient Surgery Services | Surgery | 830 Waterbury Falls Dr, O Fallon, MO 63368-2215 | 2007-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720329 | Come As You Are Counseling LLC | Counselor | 1001 Boardwalk Springs Place, Suite 111, O Fallon, MO 63368 | 2020-11-04 |
| 1770124802 | Lisa N. Greer | Technician | 6911 Brassel Dr., Ofallon, MO 63368 | 2019-09-30 |
| 1770145716 | Halie Faye Gulley | Dentist | 3009 Hwy K, O'fallon, MO 63368 | 2019-06-29 |
| 1972079556 | Erin Corsi Fraundorf | Dentist | 3009 State Hwy K, O'fallon, MO 63368 | 2018-10-22 |
| 1427579960 | Air Evac Ems, Inc. | Ambulance | 1001 Boardwalk Springs Pl Ste 250, O Fallon, MO 63368 | 2017-07-06 |
| 1528507472 | Washeck Manual Therapy LLC | Clinic/Center | 3074 Winghaven Blvd, O'fallon, MO 63368 | 2017-02-13 |
| 1639618457 | Brittany Hogan | Physical Therapist | 7412 South Outer 364, Suite B, Dardenne Prairie, MO 63368 | 2017-02-13 |
| 1124561469 | Cardinal Home Care LLC | Home Health | 18 Convent Garden Ct, O'fallon, MO 63368 | 2016-11-18 |
| 1336509272 | Sarah Marie Mudd | Counselor | 1654 Bryan Road, O'fallon, MO 63368 | 2016-03-04 |
| 1588023956 | Price-bourisaw Family Chiropractic | Chiropractor | 2917 State Highway K, O Fallon, MO 63368 | 2016-02-15 |
| Find all providers in zip 63368 | ||||
| Taxonomy Code | 2086S0105X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgery of the Hand |
| A surgeon with expertise in the investigation, preservation and restoration by medical, surgical and rehabilitative means, of all structures of the upper extremity directly affecting the form and function of the hand and wrist. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447472519 | Midwest Special Surgery, P.C. | Surgery | 830 Waterbury Falls Dr, O Fallon, MO 63368-2215 | 2007-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740616705 | Andrew J. Kochevar, Md, Pllc | Surgery | 3306 Vista Ave, Saint Louis, MO 63104-1106 | 2013-09-23 |
| 1699766980 | Subbarao Polineni | Surgery | 6 Jungerman Cir, Ste 107, St Peters, MO 63376 | 2005-11-04 |
| 1235659061 | Colin William Mcinnes | Surgery | One Barnes Jewish Hospital Plaza, Saint Louis, MO 63110 | 2017-06-22 |
| 1154561538 | Jeffrey Mark Pike | Surgery | 4921 Parkview Pl, Ste 6a, Saint Louis, MO 63110-1032 | 2009-02-25 |
| 1275714784 | Venkata Kr Bodavula | Surgery | 5600 Mexico Rd Ste 21, Saint Peters, MO 63376-1660 | 2007-11-27 |
| 1801099841 | Surgery Specialist of St. Louis | Surgery | 1035 Bellevue Ave, Suite 203, Saint Louis, MO 63117-1854 | 2007-06-07 |
| 1497974075 | St Louis University | Surgery | 1755 S Grand Blvd, Saint Louis, MO 63104-1540 | 2007-04-24 |
| 1508997529 | Nicole S Schroeder | Surgery | 4921 Parkview Pl, Ste 6a, Saint Louis, MO 63110-1032 | 2007-03-08 |
| 1639192123 | Scott Alan Langford | Surgery | 120 Ne Saint Lukes Blvd Ste 200, Lees Summit, MO 64086-6011 | 2006-07-25 |
| 1386661916 | Keith E Brandt | Surgery | 4921 Parkview Pl Ste 6g, Ste 6g, Saint Louis, MO 63110-1032 | 2006-07-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.