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3525 S National Ave Ste 205a Springfield MO 65807-7315 | |
(417) 269-9714 | |
(417) 269-9236 |
Full Name | |
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Speciality | Internal Medicine - Geriatric Medicine |
Location | 3525 S National Ave Ste 205a, Springfield, Missouri |
Authorized Official Name and Position | Jacob Mcway (SR VP & CFO) |
Authorized Official Contact | 4172698811 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 505673 Saint Louis MO 63150-5673 Ph: (417) 730-6430 | 3525 S National Ave Ste 205a Springfield MO 65807-7315 Ph: (417) 269-9714 |
NPI Number | 1114953510 |
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Provider Enumeration Date | 06/25/2006 |
Last Update Date | 09/26/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1114953510 | NPI | - | NPPES |
507289007 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
James M. Carmichael, Dc Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3108 S Fremont Ave, Springfield, MO 65804 Phone: 417-886-4910 Fax: 417-886-4910 | |
Mercy Clinic Hospitalists Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1235 E Cherokee St, Springfield, MO 65804 Phone: 417-820-2600 Fax: 417-820-2100 | |