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3650 Stardust Dr Hannibal MO 63401-2480 | |
(573) 231-0660 | |
(573) 231-0687 |
Full Name | |
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Speciality | Clinic/center - Multi-specialty |
Location | 3650 Stardust Dr, Hannibal, Missouri |
Authorized Official Name and Position | Stephen J Keppner (GRP DIR PATIENT FINANCIAL SERVICE) |
Authorized Official Contact | 5732485460 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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6500 Hospital Dr P O Box 1239 Hannibal MO 63401-6890 Ph: (573) 406-5888 | 3650 Stardust Dr Hannibal MO 63401-2480 Ph: (573) 231-0660 |
NPI Number | 1245510221 |
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Provider Enumeration Date | 08/23/2011 |
Last Update Date | 08/23/2011 |
Identifier | Type | State | Issuer |
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1245510221 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Marion County Health Dept. & Home Health Agency Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3105 Rt. W, Hannibal, MO 63401 Phone: 573-221-1166 Fax: 573-221-1214 | |