| Butterfield Park Pediatrics | |
|
1195 N Oakland Ave Suite 2 Bolivar MO 65613-8095 | |
| (417) 777-2121 | |
| (417) 777-2854 |
| Full Name | Butterfield Park Pediatrics |
|---|---|
| Speciality | Clinic/Center |
| Location | 1195 N Oakland Ave, Bolivar, Missouri |
| Authorized Official Name and Position | Donald J Babb (CEO) |
| Authorized Official Contact | 4173266000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Butterfield Park Pediatrics 1195 N Oakland Ave Bolivar MO 65613-8095 Ph: (417) 777-2121 | Butterfield Park Pediatrics 1195 N Oakland Ave Suite 2 Bolivar MO 65613-8095 Ph: (417) 777-2121 |
| NPI Number | 1942414610 |
|---|---|
| Provider Enumeration Date | 05/10/2007 |
| Last Update Date | 11/06/2018 |
| Medicare PECOS PAC ID | 4183528169 |
|---|---|
| Medicare Enrollment ID | O20080125000591 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942414610 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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