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202 N. Commercial Seymour MO 65746-8858 | |
(417) 269-2100 | |
(417) 269-2103 |
Full Name | |
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Speciality | Clinic/Center |
Location | 202 N. Commercial, Seymour, Missouri |
Authorized Official Name and Position | Jacob Mcway (SR VP & CFO) |
Authorized Official Contact | 4172698811 |
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 505673 Saint Louis MO 63150-5673 Ph: (417) 730-6430 | 202 N. Commercial Seymour MO 65746-8858 Ph: (417) 269-2100 |
NPI Number | 1558391912 |
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Provider Enumeration Date | 07/03/2006 |
Last Update Date | 09/27/2024 |
Medicare PECOS PAC ID | 1254248917 |
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Medicare Enrollment ID | O20041115000288 |
Identifier | Type | State | Issuer |
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1558391912 | NPI | - | NPPES |
592581409 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |