Full Name | |
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Speciality | Family Medicine |
Location | 100 N Main St, Gideon, Missouri |
Authorized Official Name and Position | Paula J Anderson (OFFICE ADMINISTRATOR) |
Authorized Official Contact | 5736952181 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 12545 Belfast ME 04915-4016 Ph: (573) 448-3800 | 100 N Main St Gideon MO 63848-9253 Ph: (573) 448-3800 |
NPI Number | 1497189864 |
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Provider Enumeration Date | 08/21/2013 |
Last Update Date | 10/03/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1497189864 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | R9E31 (Missouri) | Primary |