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561 Commons Drive Fulton MO 65251-1489 | |
(573) 826-2700 | |
(573) 632-2769 |
Full Name | |
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Speciality | Clinic/Center |
Location | 561 Commons Drive, Fulton, Missouri |
Authorized Official Name and Position | Toby Barnett (CHIEF FIN OFFICER) |
Authorized Official Contact | 5736320243 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 104780 Jefferson City MO 65110-4780 Ph: (573) 632-0243 | 561 Commons Drive Fulton MO 65251-1489 Ph: (573) 826-2700 |
NPI Number | 1316282239 |
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Provider Enumeration Date | 12/04/2012 |
Last Update Date | 11/18/2022 |
Medicare PECOS PAC ID | 2062456015 |
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Medicare Enrollment ID | O20130211000153 |
Identifier | Type | State | Issuer |
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1316282239 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Fulton Family Health Associates, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2613 Fairway Dr, Suite C, Fulton, MO 65251 Phone: 573-642-1990 Fax: 573-642-1866 | |
Jefferson City Medical Group, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 350 Country Meadow Ln, Fulton, MO 65251 Phone: 736-344-8785 | |