| Ebo Md Of Poplar Bluff Llc | |
|
2725 N Westwood Blvd Poplar Bluff MO 63901-2346 | |
| (573) 686-5510 | |
| Not Available |
| Full Name | Ebo Md Of Poplar Bluff Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2725 N Westwood Blvd, Poplar Bluff, Missouri |
| Authorized Official Name and Position | Philip James Crocker (CFO) |
| Authorized Official Contact | 5736865510 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ebo Md Of Poplar Bluff Llc 2725 N Westwood Blvd Ste 14 Poplar Bluff MO 63901-2367 Ph: (573) 686-5510 | Ebo Md Of Poplar Bluff Llc 2725 N Westwood Blvd Poplar Bluff MO 63901-2346 Ph: (573) 686-5510 |
| NPI Number | 1770152035 |
|---|---|
| Provider Enumeration Date | 06/22/2021 |
| Last Update Date | 07/26/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770152035 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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