Chestnut Health Of Missouri Llc | |
13700 Old Halls Ferry Rd Black Jack MO 63033-4109 | |
(314) 355-0760 | |
(703) 649-6188 |
Full Name | Chestnut Health Of Missouri Llc |
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Speciality | Internal Medicine |
Location | 13700 Old Halls Ferry Rd, Black Jack, Missouri |
Authorized Official Name and Position | Jai Kumar (ADMINISTRATOR) |
Authorized Official Contact | 7033486060 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Chestnut Health Of Missouri Llc 1530 N Randall Rd Ste 210 Elgin IL 60123-7879 Ph: (703) 348-6060 | Chestnut Health Of Missouri Llc 13700 Old Halls Ferry Rd Black Jack MO 63033-4109 Ph: (314) 355-0760 |
NPI Number | 1659195345 |
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Provider Enumeration Date | 11/11/2024 |
Last Update Date | 11/11/2024 |
Identifier | Type | State | Issuer |
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1659195345 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Long Term Care Of North County Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4401 Parker Rd, Black Jack, MO 63033 Phone: 314-312-0720 |