| Center For Diagnostic Medicine | |
|
320 W Mount Vernon Blvd Mount Vernon MO 65712-1940 | |
| (417) 461-0056 | |
| (833) 707-1944 |
| Full Name | Center For Diagnostic Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 320 W Mount Vernon Blvd, Mount Vernon, Missouri |
| Authorized Official Name and Position | Lisa Lynn Parker (PHYSICIAN) |
| Authorized Official Contact | 4174613009 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Diagnostic Medicine 320 W Mount Vernon Blvd Mount Vernon MO 65712-1940 Ph: (417) 461-0056 | Center For Diagnostic Medicine 320 W Mount Vernon Blvd Mount Vernon MO 65712-1940 Ph: (417) 461-0056 |
| NPI Number | 1962134114 |
|---|---|
| Provider Enumeration Date | 06/27/2022 |
| Last Update Date | 03/11/2023 |
| Medicare PECOS PAC ID | 9133599772 |
|---|---|
| Medicare Enrollment ID | O20221223000260 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962134114 | NPI | - | NPPES |
| 205890106 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Lisa L Parker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578682324 PECOS PAC ID: 7416055439 Enrollment ID: I20070614000158 |
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