| Heartland Family Physicains Clinic | |
|
2130 E Jackson Blvd Jackson MO 63755-2907 | |
| (573) 243-3115 | |
| (573) 243-4700 |
| Full Name | Heartland Family Physicains Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 2130 E Jackson Blvd, Jackson, Missouri |
| Authorized Official Name and Position | Ramiro Icaza (ADMINSTRATOR) |
| Authorized Official Contact | 57352433115 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Heartland Family Physicains Clinic 2130 E Jackson Blvd Jackson MO 63755-2907 Ph: (573) 243-3115 | Heartland Family Physicains Clinic 2130 E Jackson Blvd Jackson MO 63755-2907 Ph: (573) 243-3115 |
| NPI Number | 1205966645 |
|---|---|
| Provider Enumeration Date | 03/06/2007 |
| Last Update Date | 09/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205966645 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MDR7D79 (Missouri) | Primary |
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