| Jefferson Physician Network, Llc | |
|
1105 W Liberty St Farmington MO 63640-1921 | |
| (636) 933-2900 | |
| (636) 933-8017 |
| Full Name | Jefferson Physician Network, Llc |
|---|---|
| Speciality | Internal Medicine - Endocrinology, Diabetes & Metabolism |
| Location | 1105 W Liberty St, Farmington, Missouri |
| Authorized Official Name and Position | Jeff Buck (INTERIEM CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6369331000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferson Physician Network, Llc Po Box 350 Crystal City MO 63019-0350 Ph: (636) 933-1299 | Jefferson Physician Network, Llc 1105 W Liberty St Farmington MO 63640-1921 Ph: (636) 933-2900 |
| NPI Number | 1568734994 |
|---|---|
| Provider Enumeration Date | 02/01/2012 |
| Last Update Date | 02/01/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568734994 | NPI | - | NPPES |
| 1558508606 | Other | MO | NPI |
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