Full Name | |
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Speciality | General Practice |
Location | 407 Main St., Golden City, Missouri |
Authorized Official Name and Position | T J Killingsworth (CREDENTIALING) |
Authorized Official Contact | 4176815248 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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407 Main St. Golden City MO 64748 Ph: (417) 537-4311 | 407 Main St. Golden City MO 64748 Ph: (417) 537-4311 |
NPI Number | 1144557620 |
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Provider Enumeration Date | 11/04/2009 |
Last Update Date | 04/19/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1144557620 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |