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4 Ponder Executive Plz House Springs MO 63051-3431 | |
(636) 671-1563 | |
(636) 671-3364 |
Full Name | |
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Speciality | Family Medicine |
Location | 4 Ponder Executive Plz, House Springs, Missouri |
Authorized Official Name and Position | Kenneth Earl Ross (OWNER) |
Authorized Official Contact | 6366711563 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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4 Ponder Executive Plz House Springs MO 63051-3431 Ph: (636) 671-1563 | 4 Ponder Executive Plz House Springs MO 63051-3431 Ph: (636) 671-1563 |
NPI Number | 1295038354 |
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Provider Enumeration Date | 12/13/2010 |
Last Update Date | 01/06/2011 |
Identifier | Type | State | Issuer |
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1295038354 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | R9C07 (Missouri) | Primary |
Compass Health, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4300 Gravois Rd, House Springs, MO 63051 Phone: 636-321-0150 Fax: 636-375-5157 |