Crenshaw Family Practice Clinic, Pc | |
133 E Main Kahoka MO 63445-1775 | |
(660) 727-3388 | |
(660) 727-2196 |
Full Name | Crenshaw Family Practice Clinic, Pc |
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Speciality | Family Medicine |
Location | 133 E Main, Kahoka, Missouri |
Authorized Official Name and Position | Neville Q. Crenshaw (OWNER) |
Authorized Official Contact | 6607273388 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Crenshaw Family Practice Clinic, Pc 133 E Main Kahoka MO 63445 Ph: (660) 727-3388 | Crenshaw Family Practice Clinic, Pc 133 E Main Kahoka MO 63445-1775 Ph: (660) 727-3388 |
NPI Number | 1073739439 |
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Provider Enumeration Date | 04/17/2007 |
Last Update Date | 01/15/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1073739439 | NPI | - | NPPES |
242028900 | Medicaid | MO | |
000002704 | Other | MO | MEDICARE GROUP NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |