| Big Springs Medical Association | |
|
1300 Victory Ln Poplar Bluff MO 63901-3300 | |
| (573) 413-4193 | |
| (573) 413-4194 |
| Full Name | Big Springs Medical Association |
|---|---|
| Speciality | Clinic/Center |
| Location | 1300 Victory Ln, Poplar Bluff, Missouri |
| Authorized Official Name and Position | Karen R White (CEO) |
| Authorized Official Contact | 5736632313 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Big Springs Medical Association 110 S 2nd St Ellington MO 63638-9400 Ph: (573) 663-2313 | Big Springs Medical Association 1300 Victory Ln Poplar Bluff MO 63901-3300 Ph: (573) 413-4193 |
| NPI Number | 1487421863 |
|---|---|
| Provider Enumeration Date | 12/06/2023 |
| Last Update Date | 12/06/2023 |
| Medicare PECOS PAC ID | 6709871007 |
|---|---|
| Medicare Enrollment ID | O20240610000577 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487421863 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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