| Ebo Md Llc | |
|
1417 N Mount Auburn Rd Ste A Cape Girardeau MO 63701-2171 | |
| (573) 803-2941 | |
| (573) 803-0815 |
| Full Name | Ebo Md Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1417 N Mount Auburn Rd Ste A, Cape Girardeau, Missouri |
| Authorized Official Name and Position | Genni L Ourth (MANAGER) |
| Authorized Official Contact | 5738032941 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ebo Md Llc 1417 N Mount Auburn Rd Ste A Cape Girardeau MO 63701-2171 Ph: (573) 803-2941 | Ebo Md Llc 1417 N Mount Auburn Rd Ste A Cape Girardeau MO 63701-2171 Ph: (573) 803-2941 |
| NPI Number | 1326503376 |
|---|---|
| Provider Enumeration Date | 02/04/2019 |
| Last Update Date | 02/04/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326503376 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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