| Lake Regional Clinic - Osage Beach | |
|
1057 Medical Park Dr Suite A Osage Beach MO 65065-3000 | |
| (573) 302-3100 | |
| (573) 348-8279 |
| Full Name | Lake Regional Clinic - Osage Beach |
|---|---|
| Speciality | Clinic/Center |
| Location | 1057 Medical Park Dr, Osage Beach, 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 |
|---|---|
| Lake Regional Clinic - Osage Beach Po Box 801661 Kansas City MO 64180-1500 Ph: (573) 348-8000 | Lake Regional Clinic - Osage Beach 1057 Medical Park Dr Suite A Osage Beach MO 65065-3000 Ph: (573) 302-3100 |
| NPI Number | 1245520691 |
|---|---|
| Provider Enumeration Date | 04/19/2011 |
| Last Update Date | 10/12/2023 |
| Medicare PECOS PAC ID | 9133026776 |
|---|---|
| Medicare Enrollment ID | O20140331001019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245520691 | NPI | - | NPPES |
| 1245520691 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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Lake Regional Obstetrics & Gynecology Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 54 Hospital Dr Ste 201, Osage Beach, MO 65065 Phone: 573-302-2764 Fax: 573-302-2767 | |
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