Full Name | |
---|---|
Speciality | Family Medicine |
Location | 1805 Elm St, Canton, Missouri |
Authorized Official Name and Position | Maureen Kahn (PRESIDENT / CEO) |
Authorized Official Contact | 2172238400 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1005 Broadway St Quincy IL 62301-2834 Ph: (217) 223-8400 | 1805 Elm St Canton MO 63435-1685 Ph: (217) 223-8400 |
NPI Number | 1518483726 |
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Provider Enumeration Date | 08/18/2017 |
Last Update Date | 05/12/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1518483726 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
261Q00000X | Clinic/center | (* (Not Available)) | Secondary |