| Fairfax Family Medicine | |
|
309 E Main St Fairfax MO 64446-9312 | |
| (660) 686-0263 | |
| (660) 686-0262 |
| Full Name | Fairfax Family Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 309 E Main St, Fairfax, Missouri |
| Authorized Official Name and Position | Jon P Davis (CFO) |
| Authorized Official Contact | 6606862320 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairfax Family Medicine 26136 Us Highway 59 Fairfax MO 64446-9105 Ph: (660) 686-2211 | Fairfax Family Medicine 309 E Main St Fairfax MO 64446-9312 Ph: (660) 686-0263 |
| NPI Number | 1689183881 |
|---|---|
| Provider Enumeration Date | 09/20/2017 |
| Last Update Date | 10/22/2019 |
| Medicare PECOS PAC ID | 1557316783 |
|---|---|
| Medicare Enrollment ID | O20190510000487 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689183881 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Community Hospital Association Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 309 E Main St, Fairfax, MO 64446 Phone: 660-686-0263 |