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3949 Sherman Ave Saint Joseph MO 64506-3649 | |
(816) 279-4882 | |
(816) 279-4008 |
Full Name | |
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Speciality | Family Medicine |
Location | 3949 Sherman Ave, Saint Joseph, Missouri |
Authorized Official Name and Position | Steven Mark Buckles (OWNER) |
Authorized Official Contact | 8162794882 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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3949 Sherman Ave Saint Joseph MO 64506-3649 Ph: (816) 279-4882 | 3949 Sherman Ave Saint Joseph MO 64506-3649 Ph: (816) 279-4882 |
NPI Number | 1285755447 |
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Provider Enumeration Date | 04/03/2007 |
Last Update Date | 02/22/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1285755447 | NPI | - | NPPES |
21061107 | Other | MO | BLUE CROSS BLUE SHIELD |
1001146903 | Other | MO | COMMUNITY HEALTH PLAN |
2324148 | Other | MO | AETNA |
DD7089 | Other | MO | RAILROAD RETIREMENT BOARD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 105609 (Missouri) | Primary |