Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 304a E 4th St, Eldon, Missouri |
Authorized Official Name and Position | Kevin Mcroberts (CEO) |
Authorized Official Contact | 5733488756 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 801661 Kansas City MO 64180-1500 Ph: (573) 348-8000 | 304a E 4th St Eldon MO 65026-1808 Ph: (573) 392-5654 |
NPI Number | 1053427492 |
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Provider Enumeration Date | 08/21/2006 |
Last Update Date | 10/12/2023 |
Medicare PECOS PAC ID | 9133026776 |
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Medicare Enrollment ID | O20140501000205 |
Identifier | Type | State | Issuer |
---|---|---|---|
1053427492 | NPI | - | NPPES |
592540009 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Malcolm J. Dickerson, M.d., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 411 W 4th St, Eldon, MO 65026 Phone: 573-392-9200 Fax: 573-392-4626 | |
Eldon Family Chiropractic, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 102 N Business Highway 54 E Ste D, Eldon, MO 65026 Phone: 573-286-2638 | |