| Family Medicine Of Jefferson City, Llc | |
|
1616 Southridge Dr Suite #203 Jefferson City MO 65109-5677 | |
| (573) 659-7300 | |
| (573) 636-0555 |
| Full Name | Family Medicine Of Jefferson City, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1616 Southridge Dr, Jefferson City, Missouri |
| Authorized Official Name and Position | Daniel P Lavery (OWNER/PRESIDENT) |
| Authorized Official Contact | 5736597300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medicine Of Jefferson City, Llc 1616 Southridge Dr Suite #203 Jefferson City MO 65109-5677 Ph: (573) 659-7300 | Family Medicine Of Jefferson City, Llc 1616 Southridge Dr Suite #203 Jefferson City MO 65109-5677 Ph: (573) 659-7300 |
| NPI Number | 1043319957 |
|---|---|
| Provider Enumeration Date | 09/21/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043319957 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | R9J28 (Missouri) | Primary |
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