| Jibben Medical | |
|
1525 W Business Hwy 60 Dexter MO 63841 | |
| (573) 624-8447 | |
| (573) 624-4312 |
| Full Name | Jibben Medical |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 1525 W Business Hwy 60, Dexter, Missouri |
| Authorized Official Name and Position | Sue Ann Williams (CLINIC ADMINISTRATOR) |
| Authorized Official Contact | 5736241640 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jibben Medical Po Box 368 Dexter MO 63841-0368 Ph: (573) 624-3165 | Jibben Medical 1525 W Business Hwy 60 Dexter MO 63841 Ph: (573) 624-8447 |
| NPI Number | 1710056213 |
|---|---|
| Provider Enumeration Date | 11/07/2006 |
| Last Update Date | 09/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710056213 | NPI | - | NPPES |
| 504910001 | Medicaid | MO | |
| DC5219 | Other | MO | MEDICARE RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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