| Jefferson City Medical Group, P.c. | |
|
350 Country Meadow Ln Fulton MO 65251-5278 | |
| (736) 344-8785 | |
| Not Available |
| Full Name | Jefferson City Medical Group, P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 350 Country Meadow Ln, Fulton, Missouri |
| Authorized Official Name and Position | Jeffrey Patrick (PRESIDENT) |
| Authorized Official Contact | 5736355264 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferson City Medical Group, P.c. Po Box 104240 Jefferson City MO 65110-4240 Ph: () - | Jefferson City Medical Group, P.c. 350 Country Meadow Ln Fulton MO 65251-5278 Ph: (736) 344-8785 |
| NPI Number | 1649099714 |
|---|---|
| Provider Enumeration Date | 10/07/2024 |
| Last Update Date | 10/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649099714 | NPI | - | NPPES |
| 506292002 | Medicaid | MO | |
| CC7852 | Other | MO | MEDICARE RAILROAD |
| 0428190006 | Other | MO | DMERC/NORIDIAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
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