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1015 State Highway 248 Suite B Branson MO 65616-8002 | |
(417) 337-7511 | |
(417) 336-9769 |
Full Name | |
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Speciality | Family Medicine |
Location | 1015 State Highway 248, Branson, Missouri |
Authorized Official Name and Position | James Paul Lukavsky (DOCTOR) |
Authorized Official Contact | 4173377511 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1015 State Highway 248 Suite B Branson MO 65616-8002 Ph: (417) 337-7511 | 1015 State Highway 248 Suite B Branson MO 65616-8002 Ph: (417) 337-7511 |
NPI Number | 1316221963 |
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Provider Enumeration Date | 09/30/2011 |
Last Update Date | 10/25/2011 |
Medicare PECOS PAC ID | 4183896939 |
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Medicare Enrollment ID | O20111020000489 |
Identifier | Type | State | Issuer |
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1316221963 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | James P Lukavsky |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1861493983 PECOS PAC ID: 0143251975 Enrollment ID: I20050822001134 |
Drs Family Medical Clinic, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 118 N 3rd St, Branson, MO 65616 Phone: 417-334-3655 Fax: 417-334-3614 | |