Grace Family Medical Clinic, Llc | |
1206 Ward Ave Caruthersville MO 63830-2204 | |
(573) 922-5111 | |
(573) 922-5126 |
Full Name | Grace Family Medical Clinic, Llc |
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Speciality | Internal Medicine |
Location | 1206 Ward Ave, Caruthersville, Missouri |
Authorized Official Name and Position | Joseph M Kulpeksa (OWNER) |
Authorized Official Contact | 5739225111 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Grace Family Medical Clinic, Llc 1206 Ward Ave Caruthersville MO 63830-2204 Ph: (573) 922-5111 | Grace Family Medical Clinic, Llc 1206 Ward Ave Caruthersville MO 63830-2204 Ph: (573) 922-5111 |
NPI Number | 1780119651 |
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Provider Enumeration Date | 04/27/2017 |
Last Update Date | 04/27/2017 |
Identifier | Type | State | Issuer |
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1780119651 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 117451 (Missouri) | Primary |
Caruthersville Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 412 Ward Ave, Caruthersville, MO 63830 Phone: 579-333-0033 Fax: 573-333-2522 | |
Wt Regional Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 108 W 15th St, Caruthersville, MO 63830 Phone: 573-333-0033 Fax: 573-333-2522 | |