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901 Kidwell Dr Versailles MO 65084-1784 | |
(573) 378-4666 | |
(573) 378-5099 |
Full Name | |
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Speciality | Family Medicine |
Location | 901 Kidwell Dr, Versailles, Missouri |
Authorized Official Name and Position | Tom Luebbering (VP OF FINANCE) |
Authorized Official Contact | 5736325100 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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901 Kidwell Dr Versailles MO 65084-1784 Ph: (573) 378-4666 | 901 Kidwell Dr Versailles MO 65084-1784 Ph: (573) 378-4666 |
NPI Number | 1487631776 |
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Provider Enumeration Date | 12/28/2005 |
Last Update Date | 08/23/2013 |
Identifier | Type | State | Issuer |
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1487631776 | NPI | - | NPPES |
500383609 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Citizens For Health And Wellness Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 102 N Fisher St, Versailles, MO 65084 Phone: 573-378-2349 Fax: 573-378-2350 |